神经梅毒合并Miller-Fisher综合征1例_Chinese Journal of Ocular Fundus Diseases

Authors：

郭思彤 ¹ , 江汉秋 ² ,  姜利斌 ¹

1. ;
2. ;

Corresponding author：

姜利斌, Email: jlbjlb@sina.com

Keywords：

神经梅毒; 米勒·费希尔综合征; 病例报告

DOI：

10.3760/cma.j.cn511434-20210601-00283

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Citation： 郭思彤, 江汉秋, 姜利斌. 神经梅毒合并Miller-Fisher综合征1例. Chinese Journal of Ocular Fundus Diseases, 2022, 38(3): 238-240. doi: 10.3760/cma.j.cn511434-20210601-00283 Copy

1.	Wakerley BR, Uncini A, Yuki N, et al. Guillain-Barré and Miller Fisher syndromes-new diagnostic classification[J]. Nat Rev Neurol, 2014, 10(9): 537-544. DOI: 10.1038/nrneurol.2014.138.
2.	中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图及临床神经电生理学组, 中华医学会神经病学分会神经免疫学组. 中国吉兰-巴雷综合征诊治指南[J]. 中华神经科杂志, 2010, 43(8): 583-586. DOI: 10.3760/cma.j.issn.1006-7876.2010.08.018.Neuromuscular Group of Chinese Medical Association Neurology Branch, Electromyography and Clinical Neuroelectrophysiology Group of Chinese Medical Association Neurology Branch, Neuroimmunology Group of Chinese Medical Association Neurology Branch. Guidelines for diagnosis and treatment of Guillain-Barré syndrome in China[J]. Chin J Neurol, 2010, 43(8): 583-586. DOI: 10.3760/cma.j.issn.1006-7876.2010.08.018.
3.	中华人民共和国卫生行业标准-梅毒诊断[EB/OL]. (2021-06-01) [2018-03-06]. http://www.nhc.gov.cn/wjw/s9491/201803/5103a5425f9e47d29b91de38434b7f74.shtml.
4.	中国疾病预防控制中心性病控制中心, 中华医学会皮肤性病学分会性病学组, 中国医师协会皮肤科医师分会性病亚专业委员会. 梅毒、淋病、生殖器疱疹、生殖道沙眼衣原体感染诊疗指南(2014)[J]. 中华皮肤科杂志, 2014, 47(5): 365-372. DOI: 10.3760/cma.j.issn.0412-4030.2014.05.022.Venereal Disease Control Center of Chinese Center for Disease Control and Prevention, Venereal Disease Sub-Committee of Dermatology Branch of Chinese Medical Association, Venereal Disease Sub-Committee of Dermatology Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of syphilis, gonorrhea, genital herpes, and genital tract Chlamydia trachomatis infection (2014)[J]. Chin J Dermatol, 2014, 47(5): 365-372. DOI: 10.3760/cma.j.issn.0412-4030.2014.05.022.
5.	李彬. 80例以复视为首发症状的眼外肌麻痹病因分析[J]. 临床眼科杂志, 2014, 22(2): 165-168. DOI: 10.3969/j.issn.1006-8422.2014.02.023.Li B. Analysis of 80 cases of extraocular muscles paralysis with diplopia[J]. J Chin Ophthalmol, 2014, 22(2): 165-168. DOI: 10.3969/j.issn.1006-8422.2014.02.023.
6.	常现超, 俞虎, 严旺, 等. 以复视为主要症状的眼肌麻痹病因分析[J]. 中国现代医生, 2020, 58(12): 106-109.Chang XC, Yu H, Yan W, et al. Analysis of etiology of ophthalmoplegia as a main symptom[J]. China Modern Doctor, 2020, 58(12): 106-109.
7.	谢小玲, 谭塔林, 林喜湘. 21例眼肌麻痹性复视临床与病因探讨[J]. 中国神经精神疾病杂志, 2000, 26(3): 171-172. DOI: 10.3969/j.issn.1002-0152.2000.03.020.Xie XL, Tan TL, Lin XX. Discussion on the clinical and etiological factors of 21 cases of ophthalmoplegic diplopia[J]. Chin J Nerv Ment Dis, 2000, 26(3): 171-172. DOI: 10.3969/j.issn.1002-0152.2000.03.020.
8.	于静, 黄朔, 吕洋. 酷似吉兰-巴雷综合征的梅毒性脑脊髓膜炎1例报告[J]. 中风与神经疾病杂志, 2018, 35(7): 648.Yu J, Huang S, Lyu Y. A case report of syphilitic cerebrospinal meningitis resembling Guillain-Barré syndrome[J]. J Apoplexy and Nervous Diseases, 2018, 35(7): 648.
9.	蔡胜男, 许东梅, 王晓燕, 等. 眼梅毒患者临床特征分析[J]. 中国艾滋病性病, 2018, 24(9): 919-922. DOI: 10.13419/j.cnki.aids.2018.09.16.Cai SN, Xu DM, Wang XY, et al. Clinical features of ocular syphilis patients[J]. Chin J AIDS STD, 2018, 24(9): 919-922. DOI: 10.13419/j.cnki.aids.2018.09.16.
10.	樊小娟, 赵杰, 魏世辉. 神经梅毒患者22例神经眼科表现分析[J]. 国际眼科杂志, 2017, 17(10): 1985-1988. DOI: 10.3980/j.issn.1672-5123.2017.10.50.Fan XJ, Zhao J, Wei SH. Neuro-ophthalmological manifestations of neurosyphilis in 22 cases[J]. Int Eye Sci, 2017, 17(10): 1985-1988. DOI: 10.3980/j.issn.1672-5123.2017.10.50.
11.	孙晓东, 刘晖, 施辛, 等. 以复视首诊的二期梅毒一例[J]. 中华皮肤科杂志, 2008, 41(5): 317. DOI: 10.3321/j.issn:0412-4030.2008.05.027.Sun XD, Liu H, Shi X, et al. A case of secondary syphilis first diagnosed with diplopia[J]. Chin J Dermatol, 2008, 41(5): 317. DOI: 10.3321/j.issn:0412-4030.2008.05.027.
12.	Jordan K, Marino J, Damast M. Bilateral oculomotor paralysis due to neurosyphilis[J]. Ann Neurol, 1978, 3(1): 90-93. DOI: 10.1002/ana.410030114.
13.	Corr P, Bhigjee A, Lockhat F. Oculomotor nerve root enhancement in meningovascular syphilis[J]. Clin Radiol, 2004, 59(3): 294-296. DOI: 10.1016/j.crad.2003.10.019.
14.	Seeley WW, Venna N. Neurosyphilis presenting with gummatous oculomotor nerve palsy[J]. J Neurol Neurosurg Psychiatry, 2004, 75(5): 789. DOI: 10.1136/jnnp.2003.025932.
15.	孙培宏, 李爱莉, 孙杰, 等. 以动眼神经麻痹为首发症状的神经梅毒1例[J]. 中国皮肤性病学杂志, 2018, 32(4): 413-415. DOI: 10.13735/j.cjdv.1001-7089.20170061.Sun PH, Li AL, Sun J, et al. A case report of neurosyphilis with initial symptom oculomotor paralysis[J]. Chin J Derm Venereol, 2018, 32(4): 413-415. DOI: 10.13735/j.cjdv.1001-7089.20170061.
16.	袁婧, 高英, 关惠文, 等. 复视伴单侧瞳孔散大的神经梅毒1例[J]. 中国皮肤性病学杂志, 2020, 34(3): 311-312. DOI: 10.13735/j.cjdv.1001-7089.201903124.Yuan J, Gao Y, Guan HW, et al. A case of neurosyphilis with diplopia and dilated left pupil[J]. Chin J Derm Venereol, 2020, 34(3): 311-312. DOI: 10.13735/j.cjdv.1001-7089.201903124.
17.	Sakai T, Shikishima K, Mizobuchi T, et al. Bilateral tonic pupils associated with neurosyphilis[J]. Jpn J Ophthalmol, 2003, 47(4): 368-371. DOI: 10.1016/s0021-5155(03)00058-3.
18.	Stepper F, Schroth G, Sturzenegger M. Neurosyphilis mimicking Miller-Fisher syndrome: a case report and MRI findings[J]. Neurology, 1998, 51(1): 269-271. DOI: 10.1212/wnl.51.1.269.
19.	邢燕蒙, 刘沛东, 张保朝, 等. Miller-Fisher 综合征临床特点及亚型诊断(附27例报告)[J]. 中国神经免疫学和神经病学杂志, 2016, 23(3): 203-206. DOI: 10.3969/j.issn.1006-2963.2016.03.011.Xing YM, Liu PD, Zhao BC, et al. Clinical features and subtype diagnosis of Miller-Fisher syndrome (report of 27 cases)[J]. Chin J Neuroimmunol & Neurol, 2016, 23(3): 203-206. DOI: 10.3969/j.issn.1006-2963.2016.03.011.
20.	马莲, 张其梅. 4例Miller Fisher综合征临床分析[J]. 神经损伤与功能重建, 2018, 13(1): 46-47. DOI: 10.16780/j.cnki.sjssgncj.2018.01.017.Ma L, Zhang QM. Clinical analysis of 4 cases of Miller Fisher syndrome[J]. Neural Injury And Functional Reconstrcution, 2018, 13(1): 46-47. DOI: 10.16780/j.cnki.sjssgncj.2018.01.017.
21.	龚金锋, 蔡桂兰, 王瑞金, 等. 非典型Miller Fisher综合征2例[J]. 武警医学, 2019, 30(2): 150-152. DOI: 10.3969/j.issn.1004-3594.2019.02.019.Gong JF, Cai GL, Wang RJ, et al. Two cases of atypical Miller Fisher syndrome[J]. Med J Chin PAP, 2019, 30(2): 150-152. DOI: 10.3969/j.issn.1004-3594.2019.02.019.
22.	刘书平, 卢祖能, 肖哲曼, 等. 吉兰-巴雷综合征病理学和免疫机制研究进展[J]. 中国神经免疫学和神经病学杂志, 2019, 26(1): 56-59. DOI: 10.3969/j.issn.1006-2963.2019.01.014.Liu SP, Lu ZN, Xiao ZM, et al. Research progress on pathology and immune mechanism of Guillain-Barré syndrome[J]. Chin J Neuroimmunol & Neurol, 2019, 26(1): 56-59. DOI: 10.3969/j.issn.1006-2963.2019.01.014.
23.	侯慧清, 苗军, 曹润菁, 等. Miller-Fisher 综合征患者免疫球蛋白治疗前后淋巴细胞亚群的变化[J]. 脑与神经疾病杂志, 2016(2): 99-101.Hou HQ, Miao J, Cao RJ, et al. Change of lymphocyte subsets in the patients with Miller-Fisher syndrome between pre and post-therapy with intravenous immunoglobulin[J]. Journal of Brain and Nervous Diseases, 2016(2): 99-101.
24.	高晓莉, 武铮, 王剑锋, 等. 梅毒的细胞免疫学发病机制研究进展[J]. 中国艾滋病性病, 2020, 26(10): 1144-1146. DOI: 10.13419/j.cnki.aids.2020.10.33.Gao XL, Wu Z, Wang JF, et al. Research advances in pathogenesis of cytotoxicity of syphilis[J]. Chin J AIDS STD, 2020, 26(10): 1144-1146. DOI: 10.13419/j.cnki.aids.2020.10.33.
25.	唐利利, 程玉燕, 高金平, 等. 梅毒免疫学机制研究进展[J]. 中国麻风皮肤病杂志, 2017, 33(5): 317-320.Tang LL, Cheng YY, Gao JP, et al. Update of the immunopathogenesis of syphilis[J]. Chin J Lepr Skin Dis, 2017, 33(5): 317-320.
26.	陆明佳, 古丽尼沙·热合曼, 朱沂, 等. 以吉兰-巴雷综合征表现起病的神经梅毒三例报道[J]. 中华神经医学杂志, 2018, 17(10): 1054-1056. DOI: 10.3760/cma.j.issn.1671-8925.2018.10.018.Lu JM, Gulinisha·RHM, Zhu Y, et al. Three cases of neurosyphilis manifested as Guillain-Barré syndrome[J]. Chin J Neuromed, 2018, 17(10): 1054-1056. DOI: 10.3760/cma.j.issn.1671-8925.2018.10.018.
27.	朱真真, 张玉生, 郭黎. 梅毒相关性吉兰-巴雷综合征1例报告[J]. 中国神经精神疾病杂志, 2013(11): 683-684. DOI: 10.3936/j.issn.1002-0152.2013.11.012.Zhu ZZ, Zhang YS, Guo L. A case report of syphilis-related Guillain-Barré syndrome[J]. Chin J Nerv Ment Dis, 2013(11): 683-684. DOI: 10.3936/j.issn.1002-0152.2013.11.012.

1. Wakerley BR, Uncini A, Yuki N, et al. Guillain-Barré and Miller Fisher syndromes-new diagnostic classification[J]. Nat Rev Neurol, 2014, 10(9): 537-544. DOI: 10.1038/nrneurol.2014.138.
2. 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图及临床神经电生理学组, 中华医学会神经病学分会神经免疫学组. 中国吉兰-巴雷综合征诊治指南[J]. 中华神经科杂志, 2010, 43(8): 583-586. DOI: 10.3760/cma.j.issn.1006-7876.2010.08.018.Neuromuscular Group of Chinese Medical Association Neurology Branch, Electromyography and Clinical Neuroelectrophysiology Group of Chinese Medical Association Neurology Branch, Neuroimmunology Group of Chinese Medical Association Neurology Branch. Guidelines for diagnosis and treatment of Guillain-Barré syndrome in China[J]. Chin J Neurol, 2010, 43(8): 583-586. DOI: 10.3760/cma.j.issn.1006-7876.2010.08.018.
3. 中华人民共和国卫生行业标准-梅毒诊断[EB/OL]. (2021-06-01) [2018-03-06]. http://www.nhc.gov.cn/wjw/s9491/201803/5103a5425f9e47d29b91de38434b7f74.shtml.
4. 中国疾病预防控制中心性病控制中心, 中华医学会皮肤性病学分会性病学组, 中国医师协会皮肤科医师分会性病亚专业委员会. 梅毒、淋病、生殖器疱疹、生殖道沙眼衣原体感染诊疗指南(2014)[J]. 中华皮肤科杂志, 2014, 47(5): 365-372. DOI: 10.3760/cma.j.issn.0412-4030.2014.05.022.Venereal Disease Control Center of Chinese Center for Disease Control and Prevention, Venereal Disease Sub-Committee of Dermatology Branch of Chinese Medical Association, Venereal Disease Sub-Committee of Dermatology Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of syphilis, gonorrhea, genital herpes, and genital tract Chlamydia trachomatis infection (2014)[J]. Chin J Dermatol, 2014, 47(5): 365-372. DOI: 10.3760/cma.j.issn.0412-4030.2014.05.022.
5. 李彬. 80例以复视为首发症状的眼外肌麻痹病因分析[J]. 临床眼科杂志, 2014, 22(2): 165-168. DOI: 10.3969/j.issn.1006-8422.2014.02.023.Li B. Analysis of 80 cases of extraocular muscles paralysis with diplopia[J]. J Chin Ophthalmol, 2014, 22(2): 165-168. DOI: 10.3969/j.issn.1006-8422.2014.02.023.
6. 常现超, 俞虎, 严旺, 等. 以复视为主要症状的眼肌麻痹病因分析[J]. 中国现代医生, 2020, 58(12): 106-109.Chang XC, Yu H, Yan W, et al. Analysis of etiology of ophthalmoplegia as a main symptom[J]. China Modern Doctor, 2020, 58(12): 106-109.
7. 谢小玲, 谭塔林, 林喜湘. 21例眼肌麻痹性复视临床与病因探讨[J]. 中国神经精神疾病杂志, 2000, 26(3): 171-172. DOI: 10.3969/j.issn.1002-0152.2000.03.020.Xie XL, Tan TL, Lin XX. Discussion on the clinical and etiological factors of 21 cases of ophthalmoplegic diplopia[J]. Chin J Nerv Ment Dis, 2000, 26(3): 171-172. DOI: 10.3969/j.issn.1002-0152.2000.03.020.
8. 于静, 黄朔, 吕洋. 酷似吉兰-巴雷综合征的梅毒性脑脊髓膜炎1例报告[J]. 中风与神经疾病杂志, 2018, 35(7): 648.Yu J, Huang S, Lyu Y. A case report of syphilitic cerebrospinal meningitis resembling Guillain-Barré syndrome[J]. J Apoplexy and Nervous Diseases, 2018, 35(7): 648.
9. 蔡胜男, 许东梅, 王晓燕, 等. 眼梅毒患者临床特征分析[J]. 中国艾滋病性病, 2018, 24(9): 919-922. DOI: 10.13419/j.cnki.aids.2018.09.16.Cai SN, Xu DM, Wang XY, et al. Clinical features of ocular syphilis patients[J]. Chin J AIDS STD, 2018, 24(9): 919-922. DOI: 10.13419/j.cnki.aids.2018.09.16.
10. 樊小娟, 赵杰, 魏世辉. 神经梅毒患者22例神经眼科表现分析[J]. 国际眼科杂志, 2017, 17(10): 1985-1988. DOI: 10.3980/j.issn.1672-5123.2017.10.50.Fan XJ, Zhao J, Wei SH. Neuro-ophthalmological manifestations of neurosyphilis in 22 cases[J]. Int Eye Sci, 2017, 17(10): 1985-1988. DOI: 10.3980/j.issn.1672-5123.2017.10.50.
11. 孙晓东, 刘晖, 施辛, 等. 以复视首诊的二期梅毒一例[J]. 中华皮肤科杂志, 2008, 41(5): 317. DOI: 10.3321/j.issn:0412-4030.2008.05.027.Sun XD, Liu H, Shi X, et al. A case of secondary syphilis first diagnosed with diplopia[J]. Chin J Dermatol, 2008, 41(5): 317. DOI: 10.3321/j.issn:0412-4030.2008.05.027.
12. Jordan K, Marino J, Damast M. Bilateral oculomotor paralysis due to neurosyphilis[J]. Ann Neurol, 1978, 3(1): 90-93. DOI: 10.1002/ana.410030114.
13. Corr P, Bhigjee A, Lockhat F. Oculomotor nerve root enhancement in meningovascular syphilis[J]. Clin Radiol, 2004, 59(3): 294-296. DOI: 10.1016/j.crad.2003.10.019.
14. Seeley WW, Venna N. Neurosyphilis presenting with gummatous oculomotor nerve palsy[J]. J Neurol Neurosurg Psychiatry, 2004, 75(5): 789. DOI: 10.1136/jnnp.2003.025932.
15. 孙培宏, 李爱莉, 孙杰, 等. 以动眼神经麻痹为首发症状的神经梅毒1例[J]. 中国皮肤性病学杂志, 2018, 32(4): 413-415. DOI: 10.13735/j.cjdv.1001-7089.20170061.Sun PH, Li AL, Sun J, et al. A case report of neurosyphilis with initial symptom oculomotor paralysis[J]. Chin J Derm Venereol, 2018, 32(4): 413-415. DOI: 10.13735/j.cjdv.1001-7089.20170061.
16. 袁婧, 高英, 关惠文, 等. 复视伴单侧瞳孔散大的神经梅毒1例[J]. 中国皮肤性病学杂志, 2020, 34(3): 311-312. DOI: 10.13735/j.cjdv.1001-7089.201903124.Yuan J, Gao Y, Guan HW, et al. A case of neurosyphilis with diplopia and dilated left pupil[J]. Chin J Derm Venereol, 2020, 34(3): 311-312. DOI: 10.13735/j.cjdv.1001-7089.201903124.
17. Sakai T, Shikishima K, Mizobuchi T, et al. Bilateral tonic pupils associated with neurosyphilis[J]. Jpn J Ophthalmol, 2003, 47(4): 368-371. DOI: 10.1016/s0021-5155(03)00058-3.
18. Stepper F, Schroth G, Sturzenegger M. Neurosyphilis mimicking Miller-Fisher syndrome: a case report and MRI findings[J]. Neurology, 1998, 51(1): 269-271. DOI: 10.1212/wnl.51.1.269.
19. 邢燕蒙, 刘沛东, 张保朝, 等. Miller-Fisher 综合征临床特点及亚型诊断(附27例报告)[J]. 中国神经免疫学和神经病学杂志, 2016, 23(3): 203-206. DOI: 10.3969/j.issn.1006-2963.2016.03.011.Xing YM, Liu PD, Zhao BC, et al. Clinical features and subtype diagnosis of Miller-Fisher syndrome (report of 27 cases)[J]. Chin J Neuroimmunol & Neurol, 2016, 23(3): 203-206. DOI: 10.3969/j.issn.1006-2963.2016.03.011.
20. 马莲, 张其梅. 4例Miller Fisher综合征临床分析[J]. 神经损伤与功能重建, 2018, 13(1): 46-47. DOI: 10.16780/j.cnki.sjssgncj.2018.01.017.Ma L, Zhang QM. Clinical analysis of 4 cases of Miller Fisher syndrome[J]. Neural Injury And Functional Reconstrcution, 2018, 13(1): 46-47. DOI: 10.16780/j.cnki.sjssgncj.2018.01.017.
21. 龚金锋, 蔡桂兰, 王瑞金, 等. 非典型Miller Fisher综合征2例[J]. 武警医学, 2019, 30(2): 150-152. DOI: 10.3969/j.issn.1004-3594.2019.02.019.Gong JF, Cai GL, Wang RJ, et al. Two cases of atypical Miller Fisher syndrome[J]. Med J Chin PAP, 2019, 30(2): 150-152. DOI: 10.3969/j.issn.1004-3594.2019.02.019.
22. 刘书平, 卢祖能, 肖哲曼, 等. 吉兰-巴雷综合征病理学和免疫机制研究进展[J]. 中国神经免疫学和神经病学杂志, 2019, 26(1): 56-59. DOI: 10.3969/j.issn.1006-2963.2019.01.014.Liu SP, Lu ZN, Xiao ZM, et al. Research progress on pathology and immune mechanism of Guillain-Barré syndrome[J]. Chin J Neuroimmunol & Neurol, 2019, 26(1): 56-59. DOI: 10.3969/j.issn.1006-2963.2019.01.014.
23. 侯慧清, 苗军, 曹润菁, 等. Miller-Fisher 综合征患者免疫球蛋白治疗前后淋巴细胞亚群的变化[J]. 脑与神经疾病杂志, 2016(2): 99-101.Hou HQ, Miao J, Cao RJ, et al. Change of lymphocyte subsets in the patients with Miller-Fisher syndrome between pre and post-therapy with intravenous immunoglobulin[J]. Journal of Brain and Nervous Diseases, 2016(2): 99-101.
24. 高晓莉, 武铮, 王剑锋, 等. 梅毒的细胞免疫学发病机制研究进展[J]. 中国艾滋病性病, 2020, 26(10): 1144-1146. DOI: 10.13419/j.cnki.aids.2020.10.33.Gao XL, Wu Z, Wang JF, et al. Research advances in pathogenesis of cytotoxicity of syphilis[J]. Chin J AIDS STD, 2020, 26(10): 1144-1146. DOI: 10.13419/j.cnki.aids.2020.10.33.
25. 唐利利, 程玉燕, 高金平, 等. 梅毒免疫学机制研究进展[J]. 中国麻风皮肤病杂志, 2017, 33(5): 317-320.Tang LL, Cheng YY, Gao JP, et al. Update of the immunopathogenesis of syphilis[J]. Chin J Lepr Skin Dis, 2017, 33(5): 317-320.
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