脊髓梅毒临床及神经电生理4例分析

摘 要 目的：探讨脊髓梅毒临床和神经电生理特征。方法：回顾性分析近2年在我院住院治疗的4例脊髓痨患者的临床与实验室资料。结果：(1)脊髓痨的主要临床特征为: 腰腿神经痛，共济失调步态，Romberg征阳性、下肢深感觉障碍、肌张力减低、跟膝反射减弱或消失以及二便障碍；或脊髓梅毒表现为急性脊髓炎。(2)体感诱发电位均表现为下肢中枢传导速度延长；双下肢波形分化欠佳不良、波幅降低，L3、T11及皮层电位P40潜伏期延长。结论：梅毒可导致急性脊髓炎。对于中年腰腿痛、共济失调的患者应常规做梅毒血清学检查，以防止误诊。脊髓痨患者体感诱发电位提示腰段脊髓以上中枢神经受损。

A clinical and neuroelectrophysiological analysis of 4 cases of myelosyphilis

【Abstract】 Objective To study the clinical and neuroelectrophysiological characteristics of myelosyphilis. Methods We studied the clinical and laboratory data of 4 patients with myelosyphilis retrospectively in our hospital. Results (1) The main clinical characteristics of tabes dorsalis were: backleg neuralgia，gait ataxia , Romberg sign positive; impaired vibratory and position sense, reduced muscles tension，absent tendon reflexes at lower extremity and abnormal of relieve the bowels; or myelosyphilis showed as acute myelitis;（2）Somatosensory evoked potential (SEP) of tabes dorsalis all showed as lower speed of central conduction at lower extremities. Both lower extremities wave were debased and divided undesirably, and the delitescence of L3、T11 and P40 voltage was extended.Conclusions Syphilis may cause acute myelitis. In order to avoid wrong diagnosis, serological test of syphilis should be taken on the middle-aged patients who suffer from waist and leg pain and gait ataxia. SEP shows the damage of the central nerves system over the lumbar spinal of the tabes dorsalis cases.