感官性多神经病变揭示晚期发病的尿素循环缺陷
Ravi Krishna Kanth1, Naman Agrawal1, Pratik Patel1
1Department of Neurology, All India Institute of Medical Sciences, Jodhpur, India.
Clinical neurology and neurosurgery
|April 2, 2024
概括
这项案例研究突出了甲氨酸转糖酶 (OTC) 缺乏症,这是一种罕见的代谢障碍,呈现为脱髓化多神经病和肝脏脑病. 及时诊断和治疗导致了患者的康复.
科学领域:
- 神经学 神经学
- 代谢障碍 代谢障碍 代谢障碍
- 遗传学 是一个遗传学.
背景情况:
- 一名63岁的男性患有2型糖尿病和中度饮酒,在7年内出现神经症状.
- 症状包括远部下肢虚弱,感觉性无氧,紧张的神经和情绪障碍,以及家族精神疾病病史.
研究的目的:
- 为了调查患者复杂的神经表现的根本原因.
- 为了区分各种神经病变和代谢障碍.
主要方法:
- 进行了临床检查,神经传导研究,脑脊液 (CSF) 分析,以及大脑和 lumbosacral plexus 的 MRI.
- 评估了脑电图 (EEG) 和血清氨水平.
- 为了确认诊断,进行了基因检测.
主要成果:
- 神经传导研究显示了脱髓化的感觉运动多基隆性神经病变.
- 脑脊液显示出轻度的白蛋白细胞学解离,MRI显示头骨神经和神经根部变厚.
- 血清氨量升高 (201μg/dL) 和EEG三相波表明肝脏脑病,导致怀疑甲酸转糖酶 (OTC) 缺乏.
结论:
- 这名患者被诊断患有甲氨酸转糖酶 (OTC) 缺乏症,是一种尿素循环障碍.
- 用血液透析,低蛋白饮食,利法西明和酸治疗导致临床康复.
- 这一案例强调了在患有不明原因的神经症状和复发性脑病变的患者中考虑代谢障碍的重要性.
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