Neurology: SEPT9突变所致的慢性进行性肥厚性臂丛病1例

2020-08-20 zyx整理 神经科病例撷英拾粹

51岁男性,自21岁起开始出现缓慢进行性肌肉萎缩,无力和右上肢感觉异常。患者已故的母亲有一次右上肢痛性轻瘫发作。查体可见严重的肌萎缩和右上肢感觉减退。神经影像学可见明显的右侧臂丛病(图1-2)。神经电

51岁男性,自21岁起开始出现缓慢进行性肌肉萎缩,无力和右上肢感觉异常。患者已故的母亲有一次右上肢痛性轻瘫发作。查体可见严重的肌萎缩和右上肢感觉减退。神经影像学可见明显的右侧臂丛病(图1-2)。神经电生理检查提示严重的右侧臂丛病。遗传性神经病基因检测证实SEPT9基因c.278C> T(p.Ser93Phe)致病性突变,确诊为遗传性神经痛性肌萎缩。SEPT9相关疾病可表现为常染色体显性遗传的复发性或进行性肥厚性臂丛神经病。

(图1:查体可见右上肢明显的肌萎缩[A-B],主要位于肩胛带[C-E],上臂以及前臂和手的小范围[F])

(图2:A:胸部CT可见右侧肩胛带肌肉群明显整体萎缩和脂肪替代[红粗箭];B:臂丛神经冠状位MRI短tau反转恢复序列可见不对称的高信号以及右侧臂丛的前根,干和束肥大[红箭])

原始出处:Souza PVS, Gonçalves EA, Badia BML, et al. Teaching NeuroImages: Slowly progressive hypertrophic brachial plexopathy due to SEPT9 mutation. Neurology. 2020 Jul 7;95(1):e109-e110. 

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    2021-04-11 yinhl1978
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    2021-07-01 guojianrong
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    2020-08-22 别克君

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