TY - T1的多种分离脊髓病JF -神经学乔-神经病学SP - 2089 LP - 2095 - 10.12首页12 / WNL。0 b013e31821f468f六世- 76 - 24 AU -密纹唱片弗拉纳根盟——a·麦肯盟退役军人列侬AU - j·卡恩斯盟人Weinshenker盟K.N. Krecke AU - m . Matiello盟B.M. Keegan AU - b . Mokri盟A.J. Aksamit AU -中华民国Pittock Y1 - 2011/06/14 UR - //www.ez-admanager.com/content/76/24/2089.abstract N2 -目的:报告的临床表型和首页结果分离多种的脊髓病。方法:我们系统地回顾了临床、血清学和核磁共振数据(女)20日31日病人提供一个孤立的脊髓病与癌症共存:癌(肺、9;乳房,7;肾、2;甲状腺,2;卵巢和子宫内膜,2),黑素瘤(2),或其他癌症(3),或多种自身抗体与强大的癌症协会(amphiphysin-immunoglobulin G(免疫球蛋白),9;collapsin response-mediator蛋白质5-IgG 9;浦肯野细胞胞质自身抗体类型1、2;antineuronal核自身抗体(安娜)1,1; ANNA-3, 1). Results: Of 31 patients who presented with a progressive myelopathy, symptom onset was subacute in 16 (52%). The median age was 62 years. CSF abnormalities included elevated protein (>45 mg/dL), 22; pleocytosis, 15; excess oligoclonal bands (normal <4), 7. MRI cord abnormalities identified in 20 patients were longitudinally extensive (>3 vertebral segments), 14; symmetric tract or gray matter–specific signal abnormality, 15 (enhancing in 13). Myelopathy preceded cancer diagnosis in 18 patients (median interval 12 months; range 2–44). After myelopathy onset, 26 patients underwent oncologic treatment, immunosuppressive treatment (median delay to commencing immunotherapy 9.5 months [range 1–54]), or both; only 8 improved (31%). At last neurologic evaluation (median interval after onset 17 months; range 1–165 months), 16 patients (52%) were wheelchair-dependent (median time from onset to wheelchair 9 months [range 1–21]). Ten patients died after a median of 38 months from symptom onset (range 7–152). Conclusion: Symmetric, longitudinally extensive tract or gray matter–specific changes on spinal MRI should raise suspicion for a paraneoplastic myelopathy. Resulting disability is often severe. Only a minority of patients improve with treatment. ER -