Tr抗体介导小脑性共济失调一例

摘要

目的 探讨Tr抗体介导的小脑性共济失调的临床特征、血清学及脑脊液(CSF)特点和预后.方法 报道1例Tr抗体相关性小脑性共济失调患者,分析其临床和血清学及CSF特征.结果 患者青年女性,亚急性期病,逐渐加重,主要表现为言语不清、持物困难、行走不稳.查体:构音障碍,言语欠清,言语速度减慢,双侧指鼻试验与跟膝胫试验欠稳准,轮替动作右手笨拙,直线行走不能完成.血及CSF的Tr抗体阳性.经营养神经治疗,患者直线行走症状稍有好转.结论 Tr抗体相关性共济失调是免疫介导性小脑性共济失调的一种特殊类型,易合并霍奇金淋巴瘤.%Objective To discuss the clinical characteristics, serology and cerebrospinal fluid (CSF)features and prognosis of Tr antibody related cerebellar ataxia. Method A cases of anti Tr antibody related cerebellar ataxia was reported, and her clinical and serologica and CSF characteristics were analyzed. Results Young female patients presented with barylalia, holding difficulties and walking instability for 40 days. Neurological examination found dysarthria, unclear speech, slow speech rate, slight dysmetria while performing bilateral sides finger-nose test and heel-knee-shin tests, and right hand diadochokinetic test was clumsy and unbalanced tandem gait. Laboratory text for Tr antibody was positive in serum and CSF. Management of nerve treatment, the tandem gait of patients slightly improved.Conclusion Tr antibody-related ataxia is a special type of immune mediated ataxia with tumor correlation and easy to merge with Hodgkin's lymphoma.