Neurology:瘤型麻风患者可见增粗的周围神经

2019-05-27 zyx整理 神经科病例撷英拾粹

来自秘鲁丛林的52岁男性,表现为进行性远端麻木和面部肿胀4年。

来自秘鲁丛林的52岁男性,表现为进行性远端麻木和面部肿胀4年。患者脸部,躯干和四肢皮肤可见弥漫浸润(图A-B),伴斑片状针刺觉缺失。 可触及多根周围神经,包括尺神经和腓神经,此外还可见明显增粗的耳大神经(图C)和桡神经浅支(图D)。

皮肤缝隙涂片可见多达5+的抗酸杆菌。皮肤活检符合瘤型麻风病,Fite-Faraco染色呈强阳性。

麻风病患者周围神经增粗已有详细报道;然而,罕有拍摄到如此肉眼可见的情形。



(图:A:弥漫性浸润和红斑性皮肤;B:面部弥漫性浸润伴眉毛脱落;C:肉眼可见增粗的耳大神经;也可见耳垂变大;D:肉眼可见增粗的桡神经浅支)

原始出处:Ding JZ, Legua P. Visibly enlarged peripheral nerves in lepromatous leprosy. Neurology. 2019 Mar 26

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