TY - T1的多种Myeloneuropathies JF -神经学乔-神经病学SP - e632 LP首页 - e639做- 10.1212 / WNL。0000000000011218六世- 96 - 4 AU - Shailee Shah盟Rocio巴斯克斯做圣盟Neeraj Kumar说非盟-安德鲁·麦肯盟Eoin p·弗拉纳根AU -克里斯托弗·克莱因AU -肖恩·j·Pittock盟Divyanshu Dubey Y1 - 2021/01/26 UR - //www.ez-admanager.com/content/96/4/e632.abstract N2 -客观测试假设myeloneuropath首页y呈现表型的多种神经系统症状我们回顾了临床,放射和血清学的特性的32名患者伴随多种的脊髓和周围神经系统的参与。方法观察研究调查myeloneuropathy和潜在癌症患者或onconeural抗体血清阳性。结果32例多种myeloneuropathy 20(63%)是女性平均年龄61年(范围27 - 84年)。26例(81%)有分类onconeural抗体(amphiphysin n = 8;antineuronal核抗体(安娜)1型(anti-Hu), n = 5;collapsin响应中介蛋白5 [CRMP5] [anti-CV2], n = 6;浦肯野细胞胞质抗体1型[PCA1] [anti-Yo], n = 1;浦肯野细胞胞质抗体2型(PCA2), n = 2;kelch-like蛋白11 [KLHL11], n = 1;及其组合:ANNA1 / CRMP5, n = 1;ANNA1 / amphiphysin, n = 1; ANNA3/CRMP5, n = 1). Cancer was confirmed in 25 cases (onconeural antibodies, n = 19; unclassified antibodies, n = 3; no antibodies, n = 3). Paraneoplastic myeloneuropathies had asymmetric paresthesias (84%), neuropathic pain (78%), subacute onset (72%), sensory ataxia (69%), bladder dysfunction (69%), and unintentional weight loss >15 pounds (63%). Neurologic examination demonstrated concomitant distal or asymmetric hyporeflexia and hyperreflexia (81%), impaired vibration and proprioception (69%), Babinski response (68%), and asymmetric weakness (66%). MRI showed longitudinally extensive (45%), tract-specific spinal cord T2 hyperintensities (39%) and lumbar nerve root enhancement (38%). Ten of 28 (36%) were unable to ambulate independently at last follow-up (median 24 months, range 5–133 months). Combined oncologic and immunologic therapy had more favorable modified Rankin Scale scores at post-treatment follow-up compared to those receiving either oncologic or immunologic therapy alone (2 [range 1–4] vs 4 [range 2–6], p < 0.001).Conclusions Paraneoplastic etiologies should be considered in the evaluation of subacute myeloneuropathies. Recognition of key characteristics of paraneoplastic myeloneuropathy may facilitate early tumor diagnosis and initiation of immunosuppressive treatment.ANNA=antineuronal nuclear antibody; CRMP5=collapsin response mediator protein 5; IgG=immunoglobulin G; KLHL11=kelch-like protein s11; MAP1B=microtubule-associated protein 1B antibody; mRS=modified Rankin Scale; PCA=Purkinje cell cytoplasmic antibody ER -