视神经脊髓炎的脑干表现(P02.144)

摘要

摘要目的:本研究的目的是评估视神经脊髓炎(NMO)患者前瞻性队列中脑干症状的频率，并根据种族背景和抗水通道蛋白4 (AQP4)抗体的血清学状态更好地表征脑干体征。我们还评估了病史中出现这些症状的时间。

背景:NMO是一种严重的中枢神经系统脱髓鞘疾病，主要累及脊髓和视神经。然而，最近报道了NMO或NMO谱系患者的脑干症状。

设计/方法:我们根据2006年Wingerchuck标准对258名NMO患者进行了一项前瞻性多中心研究。我们前瞻性地(通过门诊或电话)评估了该人群中各种脑干体征的频率、特征和发病日期。

结果:81例(31.4%)患者出现脑干体征。最常见的是呕吐(33.1%)、打嗝(22.3%)、动眼症(19.8%)、瘙痒(12.4%)、耳聋(2.5%)和面瘫(2.5%)。还有一些前庭症状(1.7%)、三叉神经痛(2.5%)和其他颅神经体征(3.3%)。44例(54.3%)患者首次出现这些体征。在其他患者中，病程中出现脑干体征的时间从1个月延长至257个月，中位时间为15个月。我们发现非高加索人群的患病率(36.6%)高于高加索人群(26%)(p<0.05)。血清阳性患者患病率(32.7%)高于血清阴性患者(26%)，但差异无统计学意义。

结论:这些结果证实了NMO中脑干体征的相对高频率。我们发现大多数呕吐和打嗝如前所述。这些症状似乎在非高加索人群和AQP-4阳性患者中更常见，这可以通过遗传易感性来解释。在大多数患者中，脑干体征在NMO过程中是初始的或早期出现的。

披露:克雷默医生没什么可透露的。米利医生没什么可透露的。雅各布医生没什么要透露的。Nakashima博士因在拜耳先灵(Bayer Schering)、诺华(Novartis)和百健爱德(Biogen Idec)的工作而获得个人补偿。Nakashima博士得到了三菱公司的研究支持。卡布尔医生没什么可透露的。Bigi博士曾因参与瑞士多发性硬化症协会、Bangerter-Rhyner基金会和Biogen Dompe的活动而获得个人补偿。Paul博士曾因与梯瓦、赛诺菲安万特、默克雪兰诺、百健爱德、拜耳、诺华和Guthy Jackson慈善基金会的合作而获得个人补偿。Paul博士曾获得拜耳先灵、默克雪兰诺、梯瓦制药和诺华制药的研究支持。Jarius博士获得了拜耳医疗保健和默克雪兰诺的研究支持。 Dr. Aktas has received personal compensation for activities with the German Research Council (DFG SFB-TRR43, DFG GK-1033) and honoraria & travel grants from Bayer HealthCare, BiogenIdec, Merck-Sorono, Novartis, and Teva/Sanofi-Aventis. Dr. Aktas has received research support from Bayer Schering Pharma and Novartis and consulting/speaker fees from Bayer Schering Pharma, Biogen Idec, Merck Serono, Novartis, and Sanofi-Aventis. Dr. Elsone has nothing to disclose. Dr. Mutch has nothing to disclose. Dr. Levy has received personal compensation for activities with ApoPharma Inc. Dr. Levy has received research support from ApoPharma Inc. Dr. Takai has nothing to disclose. Dr. Collongues has received personal compensation for activities with Biogen Idec, Bayer Schering, Teva Neuroscience, Merck Serono, Sanofi-Aventis Pharmaceuticals, Inc., and Novartis. Dr. Banwell has received personal compensation for activities with Merck Serono, Biogen Idec, Bayer Healthcare, Teva Neuroscience, and Genzyme Corporation. Dr Banwell has received research support from the Multiple Sclerosis Society of Canada (MSSC), the Canadian Multiple Sclerosis Scientific Research Foundation and from a New Emerging Team Grant in Autoimmunity, which is supported by the Canadian Institute of Health Research and the MSSC. Dr. Fujihara has received personal compensation for activities with Bayer Schering Pharma, Biogen Idec, Chugai Pharmaceutical, and Mitsubishi Tanabe Pharma. Dr. Fujihara has received research support from Bayer Schering Pharma, Biogen Idec Japan, Asahi Kasei Kuraray Medical Co., The Chemo-Sero-Therapeutic Research Institute, Mitsubishi Tanabe Pharma Corporation, and Teijin Pharma. Dr. De Seze has received personal compensation for activities with Allergan, Inc., Almirall, Bayer Schering, Biogen Idec, Genzyme Corporation, LFB, Merck Serono, Sanofi-Aventis Pharmaceuticals, Inc., and Teva Neuroscience.