临床观察

运动神经元综合征并发干燥综合征康复1例报道

  • 米海霞 ,
  • 杜晓霞
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  • 1.中国康复研究中心北京博爱医院神经康复科,北京市 100068;
    2.首都医科大学康复医学院,北京市 100068
米海霞(1989-),女,瑶族,湖南辰溪县人,硕士,医师,主要研究方向:神经康复学。通讯作者:杜晓霞,女,博士,副主任医师。

收稿日期: 2017-09-28

  修回日期: 2018-03-13

  网络出版日期: 2018-05-24

Rehabilitation for Motor Neuron Syndrome and Sjögren's Syndrome: A Case Report

  • MI Hai-xia ,
  • DU Xiao-xia
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  • 1. Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China;
    2. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China

Received date: 2017-09-28

  Revised date: 2018-03-13

  Online published: 2018-05-24

摘要

目的 探讨运动神经元综合征并发干燥综合征的康复。方法 报道1例运动神经元综合征并发干燥综合征患者的治疗、康复及随访结局。结果 患者渐进性四肢麻痹、言语含糊,肌电图示上、下运动神经元损伤,超声示腮腺和颌下腺弥漫性病变,实验室检测示SSA和Ro52抗体升高。接受免疫球蛋白治疗和综合康复训练4周后,言语、肌力、平衡、姿势控制和日常生活能力均有改善。2个月后再接受免疫治疗,无进一步临床改善,但症状没有持续恶化。结论 运动神经元综合征并发干燥综合征患者可能会受益于静脉注射免疫球蛋白治疗和适当康复训练。

本文引用格式

米海霞 , 杜晓霞 . 运动神经元综合征并发干燥综合征康复1例报道[J]. 中国康复理论与实践, 2018 , 24(5) : 585 -591 . DOI: 10.3969/j.issn.1006-9771.2018.05.019

Abstract

Objective To explore the rehabilitation and outcome of motor neuron syndrome and Sjögren's syndrome. Methods A patient with motor neuron syndrome and Sjögren's syndrome was reviewed. Results The patient expressed progressive quadriparesis and slurred speech. Electromyogramphy displayed upper and lower motor neuron damage. Sonography showed diffuse lesions in parotid gland and submandibular gland. Laboratory tests displayed markedly elevated levels of SSA and Ro52 antibodies. After a course of intravenous immunoglobulin (IVIG) and four weeks of comprehensive rehabilitation, the patient improved in terms of speech, muscle strength, balance, posture control and activities of daily living. She failed to achieve further improvement after another IVIG and glucocorticoid two months later, but fortunately her symptoms did not deteriorate. Conclusion The patient with motor neuron syndrome and Sjögren's syndrome might benefit from IVIG and appropriate rehabilitation.

参考文献

[1] Moutsopoulos HM.Sjögren's syndrome: autoimmune epithelitis[J]. Clin Immunol Immunopathol, 1994, 72(2): 162-165.
[2] Alegria G, Guellec D, Mariette X, et al.Epidemiology of neurological manifestations in Sjögren's syndrome: data from the French ASSESS Cohort[J]. RMD Open, 2016, 2(1): e000179.
[3] Jamilloux Y, Magy L, Hurtevent J, et al.Immunological profiles determine neurological involvement in Sjögren's syndrome[J]. Eur J Intern Med, 2014, 25(2): 177-181.
[4] Delalande S, de Seze J, Fauchais AL, et al. Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients[J]. Medicine (Baltimore), 2004, 83(5): 280-291.
[5] 廖琴,樊东升. 肌萎缩侧索硬化伴干燥综合征四例临床分析[J]. 中华神经科杂志, 2012, 45(7): 467-470.
[6] Hagiwara K, Murai H, Ochi H, et al.Upper motor neuron syndrome associated with subclinical Sjögren's syndrome[J]. Intern Med, 2008, 47(11): 1047-1051.
[7] Salachas F, Lafitte C, Chassande B, et al.Motor neuron disease mimicking amyotrophic lateral sclerosis or primary lateral sclerosis in primary Sjogren's syndrome[J]. Neurology, 1998, 50(4): A31.
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