Adult paraneoplastic opsoclonus-myoclonus-ataxia syndrome: one case report

doi:10.3969/j.issn.1672-6731.2024.07.014

Abstract

Key words: Ocular motility disorders, Myoclonus, Ataxia, Paraneoplastic syndromes, nervous system, Case reports

关键词: 眼球运动障碍, 肌阵挛, 共济失调, 副肿瘤综合征，神经系统, 病例报告

Dong-xin WANG, Hai-li LU, Na CHEN. Adult paraneoplastic opsoclonus-myoclonus-ataxia syndrome: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(7): 583-588.

王冬欣, 卢海丽, 陈娜. 成人副肿瘤性眼阵挛-肌阵挛-共济失调综合征一例[J]. 中国现代神经疾病杂志, 2024, 24(7): 583-588.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2024.07.014

https://journal11.magtechjournal.com/cjcnn/EN/Y2024/V24/I7/583

Figures/Tables 3

References 43

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序号	文献来源	性别	年龄（岁）	临床表现	抗体	肿瘤类型	治疗	预后
1	黄敏^[3]（2021）	男性	65	眼阵挛、肌阵挛、共济失调	-	膀胱癌	原发肿瘤治疗、IVIg	部分缓解
2	黄显军等^[1]（2016）	男性	61	头晕、眼阵挛、肌阵挛、睡眠障碍、精神症状	-	肺癌	糖皮质激素、氯硝西泮	部分缓解
3	刘步珍^[20]（2005）	男性	63	眼阵挛、肌阵挛、共济失调	—	小细胞肺癌	原发肿瘤治疗	完全缓解
4	Jones和Chen^[21]（2022）	女性	27	恶心、头晕、步态不稳、眼阵挛、体位性震颤、动作性肌阵挛、宽基步态	-	卵巢癌	糖皮质激素、IVIg、利妥昔单抗	迅速缓解，随访30个月无复发
5	Miraclin等^[2]（2023）	女性	28	共济失调、全身震颤、肌阵挛、癫痫发作、精神行为异常，睡眠障碍	-	卵巢畸胎瘤	原发肿瘤治疗、糖皮质激素	完全缓解，随访2年所有日常生活活动均可独立完成
6	Kostoglou等^[18]（2021）	女性	43	癫痫发作、眼球运动障碍、共济失调、幻听、失眠	抗Ri抗体（+）	乳腺癌	血浆置换、糖皮质激素	部分缓解
7	Taib等^[22]（2015）	女性	50	头晕、精神错乱、步态不稳、眼阵挛、肌阵挛、小脑功能障碍	-	鼻咽癌	原发肿瘤治疗、糖皮质激素、IVIg	部分缓解
8	Blaes等^[23]（2003）	女性	58	斜视性眼阵挛、肌阵挛、共济失调	AMA（+）	小细胞肺癌	原发肿瘤治疗、糖皮质激素	遗留轻度共济失调
9	Rosenow等^[24]（2022）	女性	46	恶心、呕吐、眩晕、构音障碍、肌阵挛、眼阵挛、步态不稳	肌肉乙酰胆碱受体结合抗体（+），抗CASPR2抗体（+）	肺癌	原发肿瘤治疗、血浆置换、糖皮质激素、IVIg	死亡
10	Nwafor等^[12]（2019）	女性	72	眼阵挛、腹肌阵挛、共济失调	抗VGKC抗体（+）	胰腺癌	原发肿瘤治疗、糖皮质激素、劳拉西泮、左乙拉西坦	死亡
11	Sena等^[7]（2020）	女性	72	视物模糊、复视、步态障碍	抗Ri抗体（+）	乳腺癌	原发肿瘤治疗	部分缓解
12	Grubbs等^[25]（2016）	女性	53	眼阵挛、肌阵挛、抽搐、失衡、言语不清、认知功能减退	-	DLBCL	IVIg、糖皮质激素、甲氨蝶呤、长春新碱、利妥昔单抗	死亡
13	Stewart等^[26]（2019）	女性	54	肢体震颤、斜视性眼阵挛、面部和双上肢肌强直性抽搐	抗Ri抗体（+）	卵巢癌	原发肿瘤治疗、糖皮质素、氯硝西泮	神经系统症状完全缓解，随访10年未复发但肿瘤复发
14	Mahesh等^[27]（2019）	女性	14	斜视性眼阵挛、肌阵挛、共济失调	-	卵巢畸胎瘤	原发肿瘤治疗、IVIg、糖皮质激素	完全缓解
15	Martins等^[28]（2019）	女性	49	睡眠障碍、眼阵挛、肌阵挛、共济失调	抗Ri抗体（+）	乳腺癌	原发肿瘤治疗、他莫昔芬、糖皮质激素、利妥昔单抗、氯硝西泮、左乙拉西坦	6个月后抗Ri抗体转阴，未复发
16	Laroumagne等^[29]（2014）	男性	65	共济失调、肌阵挛、眼球震颤	抗GAD65抗体（+）	小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
17	Musunuru等^[30]（2008）	女性	63	恶心、眩晕、构音障碍、步态不稳、斜视性眼阵挛、肌阵挛	抗Ri抗体（+）	非小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
18	Moreira等^[31]（2022）	男性	69	眩晕、恶心、呕吐、构音障碍、眼球震颤、肌阵挛、共济失调	-	小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
19	Reinecke等^[32]（2022）	女性	33	恶心、呕吐、头部震颤、构音障碍、肌阵挛、斜视性眼阵挛、共济失调	-	胰腺神经内分泌肿瘤	糖皮质激素、血浆置换	遗留共济失调
20	Soares等^[33]（2022）	女性	53	眩晕、恶心、呕吐、四肢抽搐、精运动不能、步态异常	-	乳腺癌	原发肿瘤治疗、糖皮质激素、利妥昔单抗	3个月后偶尔出现眩晕和轻微手部震颤
21	本文患者	女性	56	头晕、眼阵挛、肌阵挛、共济失调	抗Ri抗体（+）	无	IVIg、糖皮质激素	16个月后死于肺部感染

序号	文献来源	性别	年龄（岁）	临床表现	抗体	肿瘤类型	治疗	预后
1	黄敏^[3]（2021）	男性	65	眼阵挛、肌阵挛、共济失调	-	膀胱癌	原发肿瘤治疗、IVIg	部分缓解
2	黄显军等^[1]（2016）	男性	61	头晕、眼阵挛、肌阵挛、睡眠障碍、精神症状	-	肺癌	糖皮质激素、氯硝西泮	部分缓解
3	刘步珍^[20]（2005）	男性	63	眼阵挛、肌阵挛、共济失调	—	小细胞肺癌	原发肿瘤治疗	完全缓解
4	Jones和Chen^[21]（2022）	女性	27	恶心、头晕、步态不稳、眼阵挛、体位性震颤、动作性肌阵挛、宽基步态	-	卵巢癌	糖皮质激素、IVIg、利妥昔单抗	迅速缓解，随访30个月无复发
5	Miraclin等^[2]（2023）	女性	28	共济失调、全身震颤、肌阵挛、癫痫发作、精神行为异常，睡眠障碍	-	卵巢畸胎瘤	原发肿瘤治疗、糖皮质激素	完全缓解，随访2年所有日常生活活动均可独立完成
6	Kostoglou等^[18]（2021）	女性	43	癫痫发作、眼球运动障碍、共济失调、幻听、失眠	抗Ri抗体（+）	乳腺癌	血浆置换、糖皮质激素	部分缓解
7	Taib等^[22]（2015）	女性	50	头晕、精神错乱、步态不稳、眼阵挛、肌阵挛、小脑功能障碍	-	鼻咽癌	原发肿瘤治疗、糖皮质激素、IVIg	部分缓解
8	Blaes等^[23]（2003）	女性	58	斜视性眼阵挛、肌阵挛、共济失调	AMA（+）	小细胞肺癌	原发肿瘤治疗、糖皮质激素	遗留轻度共济失调
9	Rosenow等^[24]（2022）	女性	46	恶心、呕吐、眩晕、构音障碍、肌阵挛、眼阵挛、步态不稳	肌肉乙酰胆碱受体结合抗体（+），抗CASPR2抗体（+）	肺癌	原发肿瘤治疗、血浆置换、糖皮质激素、IVIg	死亡
10	Nwafor等^[12]（2019）	女性	72	眼阵挛、腹肌阵挛、共济失调	抗VGKC抗体（+）	胰腺癌	原发肿瘤治疗、糖皮质激素、劳拉西泮、左乙拉西坦	死亡
11	Sena等^[7]（2020）	女性	72	视物模糊、复视、步态障碍	抗Ri抗体（+）	乳腺癌	原发肿瘤治疗	部分缓解
12	Grubbs等^[25]（2016）	女性	53	眼阵挛、肌阵挛、抽搐、失衡、言语不清、认知功能减退	-	DLBCL	IVIg、糖皮质激素、甲氨蝶呤、长春新碱、利妥昔单抗	死亡
13	Stewart等^[26]（2019）	女性	54	肢体震颤、斜视性眼阵挛、面部和双上肢肌强直性抽搐	抗Ri抗体（+）	卵巢癌	原发肿瘤治疗、糖皮质素、氯硝西泮	神经系统症状完全缓解，随访10年未复发但肿瘤复发
14	Mahesh等^[27]（2019）	女性	14	斜视性眼阵挛、肌阵挛、共济失调	-	卵巢畸胎瘤	原发肿瘤治疗、IVIg、糖皮质激素	完全缓解
15	Martins等^[28]（2019）	女性	49	睡眠障碍、眼阵挛、肌阵挛、共济失调	抗Ri抗体（+）	乳腺癌	原发肿瘤治疗、他莫昔芬、糖皮质激素、利妥昔单抗、氯硝西泮、左乙拉西坦	6个月后抗Ri抗体转阴，未复发
16	Laroumagne等^[29]（2014）	男性	65	共济失调、肌阵挛、眼球震颤	抗GAD65抗体（+）	小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
17	Musunuru等^[30]（2008）	女性	63	恶心、眩晕、构音障碍、步态不稳、斜视性眼阵挛、肌阵挛	抗Ri抗体（+）	非小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
18	Moreira等^[31]（2022）	男性	69	眩晕、恶心、呕吐、构音障碍、眼球震颤、肌阵挛、共济失调	-	小细胞肺癌	原发肿瘤治疗、糖皮质激素	死亡
19	Reinecke等^[32]（2022）	女性	33	恶心、呕吐、头部震颤、构音障碍、肌阵挛、斜视性眼阵挛、共济失调	-	胰腺神经内分泌肿瘤	糖皮质激素、血浆置换	遗留共济失调
20	Soares等^[33]（2022）	女性	53	眩晕、恶心、呕吐、四肢抽搐、精运动不能、步态异常	-	乳腺癌	原发肿瘤治疗、糖皮质激素、利妥昔单抗	3个月后偶尔出现眩晕和轻微手部震颤
21	本文患者	女性	56	头晕、眼阵挛、肌阵挛、共济失调	抗Ri抗体（+）	无	IVIg、糖皮质激素	16个月后死于肺部感染

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Adult paraneoplastic opsoclonus-myoclonus-ataxia syndrome: one case report

成人副肿瘤性眼阵挛-肌阵挛-共济失调综合征一例

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Adult paraneoplastic opsoclonus-myoclonus-ataxia syndrome: one case report

成人副肿瘤性眼阵挛-肌阵挛-共济失调综合征一例

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