以顽固性呕吐起病的视神经脊髓炎谱系疾病2例并文献复习

Two Cases of Neuromyelitis Optica Spectrum Disease with Refractory Vomiting As the Initial Symptom and Literature Review

视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)是一种少见的免疫介导的中枢神经系统疾病。长节段脊髓炎(>3个椎体)、严重视神经炎和/或顽固性呕吐和呃逆极后区综合征(area postrema syndrome,APS)是该病的典型表现。其中有些病例以顽固性恶心、呕吐、呃逆为唯一的首发表现,早期易误诊、漏诊,造成诊疗延误。该文报道2例以顽固性恶心、呕吐、呃逆起病的视神经脊髓炎谱系疾病,以期为该类病例的及早正确诊治提供启示。

Neuromyelitis optica spectrum disorder(NMOSD)is a rare immune-mediated central nervous system disease.Long-segment myelitis(>3 vertebrae),severe optic neuritis and/or intractable vomiting and hiccups(area postrema syndrome,APS)are typical manifestations of the disease.Some cases with intractable nausea,vomiting,hiccups as the only initial symptom,result in early misdiagnosis and missed diagnosis,which delayed correct diagnosis and treatment.This article reports 2 cases of neuromyelitis optica spectrum disorders with intractable nausea,vomiting and hiccups as the initial symptom,in order to provide inspiration for the early and correct diagnosis and treatment of this disease.