Bernasconi A, Kuntzer T, Ladbon N, Janzer R C, Yersin B, Regli F
Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
Rev Neurol (Paris). 1996 Nov;152(11):688-94.
The neurological complications observed in 6 HIV negative intravenous drug users are reported. Four developed acute neuromuscular involvement in a lumbosacral or brachial distribution with rhabdomyolysis, myoglobinuria, hypovolemia, renal and hepatic failure in the 3 most severely affected patients. Despite evidence of immunologic abnormalities and especially presence of anti-heroin antibodies, we feel that causative mechanisms include mixed compression and ischemia with an underlying toxic myopathy, resulting in segmental myopathy with secondary compression of peripheral nerves. Two patients developed myelopathy with acute or chronic onset. The mechanisms were vascular with spinal cord infarction in the acute form and probably infectious with secondary compressive arachnoiditis in the chronic form. In these 2 patients with myelopathy, outcome was poor.
报告了在6名HIV阴性静脉吸毒者中观察到的神经并发症。4人出现急性神经肌肉受累，呈腰骶部或臂部分布，3名受影响最严重的患者出现横纹肌溶解、肌红蛋白尿、血容量不足、肾衰竭和肝衰竭。尽管有免疫异常的证据，尤其是存在抗海洛因抗体，但我们认为致病机制包括混合性压迫和缺血，伴有潜在的中毒性肌病，导致节段性肌病并继发周围神经受压。2名患者出现急性或慢性脊髓病。机制为急性形式的血管性脊髓梗死，慢性形式可能为感染性继发压迫性蛛网膜炎。在这2例脊髓病患者中，预后较差。
