多发性硬化伴发作性瘙痒20例临床分析

Clinical analysis of 20 cases of multiple sclerosis accompanied paroxysmal itching

目的探讨多发性硬化(MS)伴发作性瘙痒的临床特点。方法回顾性分析20例MS伴发作性瘙痒患者的临床资料。结果本组19例(95.0%)患者为女性,12例(60.0%)发作性瘙痒出现在首次病程,3例为MS的首发症状。瘙痒以头颈为主,突发突止,持续时间短,反复发作,瘙痒区域均伴有其他感觉障碍。MRI显示病灶位于延髓10例(头颅MRI检查15例)、颈髓11例(脊髓MRI检查14例)。卡马西平等治疗后发作性瘙痒消失。结论 MS伴发作性瘙痒多为女性,发作性瘙痒有共同的临床特征,可能与延髓、颈髓病变有关,卡马西平治疗有效。

Objective To explore the clinical features of multiple sclerosis（MS） accompanied paroxysmal itching.Methods The clinical data of the 20 MS patients accompanied paroxysmal itching were analyzed retrospectively.Results In this group,19 cases （95.0%） were female. Paroxysmal itching was appeared in the first course of MS in 12 cases （60.0%）; and which was the first symptom in 3 cases. The itching was mostly located in head and neck,with a short duration,bursted and stoped suddenly and relapsed. There were other sensory disturbances in the itching region. According to MRI,the lesion of 10 cases（15 cases with cranium MRI）was located at the medulla oblongata,11 cases（14 cases with spinal cord MRI） at the cervical cord.The paroxysmal itching was disappeared by Carbamazepine therapy.Conclusion The most MS patients with paroxysmal itching are female.The paroxysmal itching has collective clinical feature and may be related with medulla and cervical cord lesion. Carbamazepine treatment is effectual.