Transverse Myelitis
Transverse Myelitis
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DOI：
10.1056/nejmcp1001112
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发表时间：
2010-08-05
影响因子：
158.5
通讯作者：
Wingerchuk, Dean M.
中科院分区：
文献类型：
--
作者：
Frohman, Elliot M.;Wingerchuk, Dean M.
一名健康的28岁女性因3天前开始的进行性虚弱而到急诊科就诊。她报告行走困难，乳房以下的身体麻木，尿急，她注意到颈部屈曲会触发辐射到尾骨的电感觉。体格检查显示中度轻瘫伴反射亢进，左侧足底伸肌反应，振动和本体感觉受损，感觉水平T6。磁共振成像（MRI）显示下颈髓病变，增强后钆管理，发现是一致的横肌萎缩。应该如何进一步评估和治疗？
An otherwise healthy 28-year-old woman presents to the emergency department with progressive weakness that began 3 days earlier. She reports difficulty walking, numbness in the body below her breasts, and urinary urgency, and she notes that neck flexion triggers an electrical sensation that radiates to the coccyx. Physical examination reveals moderate paraparesis with hyperreflexia, a left extensor plantar response, impairment of vibratory and proprioceptive sensation, and a sensory level at T6. Magnetic resonance imaging (MRI) reveals a lower cervical cord lesion that enhances after gadolinium administration, a finding that is consistent with transverse myelitis. How should she be further evaluated and treated?