在成年人肠道毒性肉毒症中增强马尾神经根
Ruiji Jiang1, Benjamin Beland2,3, Vinil Shah4
1Department of Neurology, University of California, San Francisco, USA. ruiji.jiang@ucsf.edu.
BMC neurology
|August 23, 2025
概括
这项病例研究报告了成年肠道毒素性肉毒症 (AITB) 患者在MRI上首次出现增厚的尾巴神经根. 即使有不寻常的成像发现,
科学领域:
- 神经学
- 传染性疾病
- 放射学
背景情况:
- 成人肉毒症是一种罕见的,危及生命的疾病,由肉毒神经毒素 (BoNT) 引起.
- 急性肠道毒性肉毒症 (AITB) 是一种不常见的亚型,涉及Clostridium botulinum的肠道殖民.
- 诊断依赖于检测BoNT和隔离C. botulinum,电诊断和成像发挥支持性或排除性的作用.
研究的目的:
- 报告成年人肠道毒性肉毒症的第一个神经成像异常发现.
- 突出AITB的诊断和管理考虑,特别是在进行神经成像时.
主要方法:
- 一名74岁的男性出现了渐进的神经肌肉.
- 磁共振成像 (MRI) 显示尾巴马神经根变厚和增强.
- 通过在血液/便中检测到BoNT类型A,并从便中分离出C. botulinum,诊断得到证实;治疗包括七价性肉毒抗毒素.
主要成果:
- 患者表现出脱关节症,眼力衰竭和四眼衰竭的症状, 需要机械呼吸.
- 磁力共振成像显示出尾巴神经根的加厚和增强,模仿吉林巴雷综合征.
- 实验室测试证实了AITB,患者在服用抗毒素后的运动功能逐渐恢复.
结论:
- 这是第一个在成年人肉毒症,特别是AITB的MRI上报告的尾巴神经根异常病例.
- 当临床怀疑很高时,神经成像中发现的异常,虽然很少见,但不应妨碍及时的经验治疗.
- 了解肉毒症的差异诊断,病理生理学和治疗对于有效的患者管理至关重要.
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