文摘
摘要目的:本病例报告描述男性与表面的铁尘肺诊断中枢神经系统和自主神经功能失调有关。
背景:表面的铁尘肺是一种障碍,含铁血黄素沉积在大脑的软膜的表面和/或脊髓和通常是与听力损失的临床三和弦,共济失调,脊髓病。自主障碍不是广泛报道。
案例介绍:一名56岁男子步态障碍和不平衡被称为2颈椎手术假定受压脊髓病。到了71岁他发达的小脑性共济失调,双边感音神经性听力损失,痉挛性下肢轻瘫,感觉性共济失调,周边感觉丧失,尿潴留,早期认知变化,和抑郁。76岁的他发达的直立性低血压,直立性头痛、衣架疼痛综合征。
结果:磁共振成像的大脑和脊柱透露漫射表面铁尘肺的证据。计算机断层扫描在C4-5脊髓x光像暗示他是硬脑膜的撕裂的。实验室测试屏幕感觉丧失的常见原因和周围神经病变稀松平常的。神经传导研究和肌电图符合轻度远端感觉/运动多神经病和与年龄相关的变化,这并没有解释他的症状的严重程度。自主反射测试显示证据distal-predominant节后的同情催汗的功能障碍与心血管肾上腺素能失败伴随着直立性低血压。
结论:这种情况下是一个肤浅的铁尘肺患者的大脑和脊髓的开发自主故障表现为直立性低血压。之前的案例报告表明polyradiculopathy和轴突多神经病也可能与表面的铁尘肺。我们假设外围自主纤维可能会影响到相同的未知的机制。我们还假设可能有自主的核心组件失败,在这种情况下,考虑到脑干的参与。这种情况下支持表面铁尘肺的可能性可能会导致自主神经功能失调与外围和中心表现。
披露:Ollesch博士没有披露。Thulin博士没有披露。Lubdha沙没有披露。他已经收到了:个人薪酬在5000 - 9999美元的范围作为一致的健康顾问。他已经收到了:个人薪酬在5000 - 9999美元的范围为在科学咨询服务或数据安全监测委员会Cytokinetics。他已经收到了:个人薪酬在500 - 4999美元的范围在Alexion演讲人。他已经收到了:个人薪酬在500 - 4999美元的范围在扬声器太医药管理局服务。他已经收到了:个人薪酬在5000 - 9999美元的范围在Grifols演讲人。他已经收到了来自出版物出版版税:有关卫生保健。他已经收到了来自出版物出版版税:有关卫生保健。 Dr. Bromberg has received publishing royalties from a publication relating to health care. Dr. Bromberg has received personal compensation in the range of $5,000-$9,999 for serving as a Medical reviewer with Department of Justice, Vaccination Compensation Board. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Invex therapeutics. Dr. Digre has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for American Headache Society. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuro-ophthalmology. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Utah Womens Health Review. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received publishing royalties from a publication relating to health care. Dr. Digre has received publishing royalties from a publication relating to health care. The institution of Dr. Cortez has received research support from NIH NINDS. The institution of Dr. Cortez has received research support from Amgen Independent Investigator Award.
