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Neurology:容易误诊为重症肌无力的Leigh综合征

2017-11-18 杨中华 脑血管病及重症文献导读

CSF乳酸升高。线粒体基因组检测显示MT-APT6A基因homoplasmic T9176C突变,为Leigh综合征致病基因突变。

20岁,男性。

双侧易疲劳性上睑下垂1个月。

查体发现,双侧不全上睑下垂。向上凝视时加重(下图A),休息时改善(下图B):



重症肌无力相关检查阴性。

脑MRI T2和DWI(下图)显示导水管周围灰质对称性高信号:



CSF乳酸升高。线粒体基因组检测显示MT-APT6A基因homoplasmic T9176C突变,为Leigh综合征致病基因突变。

其发病机制作者认为:fatigable ptosis may be ascribed to the dysfunction at centrally located synapse between the nuclear complex of the third nerve and supranuclear pathways.

原始出处:

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    2017-12-01 yinhl1978
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    2017-11-18 happsf

    好好学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1931370, encodeId=7c0f19313e070, content=<a href='/topic/show?id=e13210802b2' target=_blank style='color:#2F92EE;'>#Leigh综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10802, encryptionId=e13210802b2, topicName=Leigh综合征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Dec 26 09:32:00 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000186, encodeId=024d200018623, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Dec 01 07:32:00 CST 2017, time=2017-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431016, encodeId=3a011431016b0, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Nov 20 01:32:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436656, encodeId=95091436656e5, content=<a href='/topic/show?id=e7c18092578' target=_blank style='color:#2F92EE;'>#肌无力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80925, encryptionId=e7c18092578, topicName=肌无力)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Nov 20 01:32:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262302, encodeId=4b1626230266, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Sat Nov 18 15:46:51 CST 2017, time=2017-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262242, encodeId=3c6726224246, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sat Nov 18 10:54:06 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-18 戒馋,懒,贪

    谢谢分享学习了

    0

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