Abstract:ObjectiveTo explore the diagnostic features of paraneoplstic syndrome(PNS) presented with stiff-person syndrome(SPS).MethodsOne patient with SPS caused by tumor was diagnosed as paraneoplastic neurological syndrome.The relevant literatures were reviewed.ResultsOne patient was mainly presented with rigidity,muscular spasm and epilepsy;the cerebro-spinal fluid (CSF) protein content and CSF cell count were normal.The anti-potassium channel antibody,anti-Nmethyl-D-aspartate receptor antibody,anti-glutamate decarboxylase antibody and anti-herpes simplex virus antibody were all negative.The electromyography revealed continuous motor unit activity.The sphenoid ridge meningoma was found on cerebral enhanced MR.Mild cervical disc herniation was presented on cervical spine MR.Chest CT showed multiple swollen lymph nodes in mediastinal and supradavicular and the pathologic result of the supraclavicular lymph node showed metastatic small cell cancer.ConclusionsFor patients presented as SMS without particular causes,the general examinations,especially the chest examinations are essential for diagnosis.
[1]季朝亮.副肿瘤综合征的神经系统损害[J].神经疾病与精神卫生, 2008,8(3): 230-231.
[2]Moersch FP,Woltman HW.Progressive fluctuating muscular rigidity and spasm (“stiff-man syndrome”);report of a case and some observations in 13other cases[J].Proc Staff Meet Mayo Clin,1956,31(15):421-427.
[3]Toro C, Jacobowitz DM, Hallett M. Stiff-man syndrome[J].Semin Neurol,1994,14(2):54-58.
[4]Barker RA,Revesz T,Thom M,et al.Review of 23 patients affected by the stiff man syndrome:clinical subdivision into stiff trunk(man) syndrome,stiff limb syndrome,andprogressive encephalomyelitis with rigidity[J].J Neurol Neurosurg Psychiat,1998,65(5):633-640.
[5]Lorish TR,Thorsteinsson G,Howard FM Jr.Stiff-man syndrome updated[J].Mayo Clin Proc,1989,64(6):629-636.
[6]Dalakas MC,Fujii M.The Clinical spectrum of anti-GAD antibodypositive patients with stiff-person syndrome[J].Neurology,2000,55(10):1531-1535.
[7]De Camilli P,Thomas A,Coflell R,et al.The synaptic vesicle-associated protein amphiphysin is the 128-kD autoantigen of Stiff-Man syndrome with breast cancer[J].J Exp Med,1993,178(6):2219-2223.
[8]陈健华,刘秀琴,郭玉璞,等.北京协和医院1990-2000年副肿瘤综合征住院病历总结[J].中风与神经疾病杂志,2002,19(2):96-97.
[9]Croft PB,Wilkinson M.The incidence of carcinomatous neuropathy in patients with various types of carcinoma[J].Brain,1965,88(3):427-434.
[10]宋璐,刘爱华.抗NMDA受体脑炎七例临床分析[J].中华医学杂志,2013,93(31):2508-2510.
[11]刘娟丽,王莉.抗NMDA受体脑炎新进展[J].中风与神经疾病杂志,2012,29(2):190-192.
[12]任海涛,赵燕环,关鸿志,等.抗Hu抗体检测在神经系统副肿瘤综合征诊断中的临床意义[J].中国神经免疫学和神经病学杂志,2011,18(5):332-335.
[13]Coté-Mantha E,Savard M.Paraneoplastic anti-HU syndrome associated with uterine tumor.The Canadian Journal of Neurological Sciences[J].Can J Neurol Sci,2012,39(2):254-255.
[14]Samejima S,Tateishi T,Arahata H,et al.A case of Anti-Hu antibody-and anti GluR epsilon2 antibody-positive paraneo-plastic neurological syndrome presenting with limbic encephalitis and peripheral neuropathy[J].Rinsho Shinkeigaku,2010,50(7):467-472.
[15]康宏,王冬梅,张玉涛,等.老年神经系统副肿瘤综合征22例临床分析[J].卒中与神经疾病,2010,17(6):371-372.
[16]靳桂红,李阳,范波胜.神经系统副肿瘤综合征16例临床分析[J].中国实用神经疾病杂志,2013,16(6):57-58.
[17]Graus F,Delattre JY,Antoine JC,et al.Recommended diagnostic critefia for paraneoplastic neurological syndromes[J].J Neurol Neurosurg Psychiatry,2004,75(8):1135-1140.
[18]Luca N,Daengsuwan T,Dalmau J,et al.Anti-Nmethyl-D-aspartate receptor encephalitis:a newly recognized inflammatory brain disease in children[J].Arthritis Rheum,2011,63(8):2516-2522.
[19]Vedeler CA,Antoine JC,Giometto B,et al.Management of paraneoplastic neurological syndromes:report of an EFNS Task Force[J].Eur J Neuro,2006,13(7):682-690.
[20]Lalani N,Haq R.Prognostic effect of early treatment of paraneoplastic limbic encephalitis in a patient with small-cell lung cancer[J].Curr Oncol,2012,19(5):353-357.
[21]Grisold W,Giometto B,Vitaliani R,et al.Current approaches to the treatment of paraneoplastic encephalitis[J].Ther Adv Neurol Disord,2011,4(4):237-248.