以神經根痛爲最初表現的視神經脊髓炎：病例報告

Radicular Pain as an Initial Presentation in Neuromyelitis Optica: A Case Report

10.6315/2010.38(4)08

賴彥州(Yen-Chou Lai)；劉文勝(Wen-Sheng Liu)；林詩凡(Shih-Fan Lin)；郭璨銘(Tsam-Ming Kuo)；廖恪修(Ker-Hsiu Liao)；賴彥廷(Yen-Ting Lai)

視神經脊髓炎 ； 脊髓炎 ； 視神經炎 ； 神經根痛 ； 背痛 ； neuromyelitis optica ； myelitis ； optic neuritis ； radicular pain ； back pain

台灣復健醫學雜誌

38卷4期（2010 / 12 / 01）

263 - 267

繁體中文

視神經脊髓炎是一種罕見的去髓鞘疾病，過去並無單發型視神經脊髓炎以神經根痛爲最初表現之報告。我們報告一位單發型視神經脊髓炎的個案，是一位69歲女性背痛1年（從2004年6月至2005年5月）且痛會傳到雙下肢。最初診斷爲第五腰椎神經根病變。2005年2月15日接受雷射椎間盤切除術，術後疼痛加劇，兩腿無力且雙眼視力惡化。術後三週，她來本院就醫，住院檢查後證實是視神經脊髓炎。經類固醇治療，病患下肢運動功能快速恢復，但視力依然不好。單發型的視神經脊髓炎以神經根痛爲最初表現的情形很罕見，若無持續追蹤和完整的病史，可能會延遲診斷和喪失早期治療的機會。

Neuromyelitis optica is a rare demyelinating disease. Radicular pain as the initial presentation of monophasic neuromyelitis optica has not been previously reported. We present a case of monophasic neuromyelitis optica in a 69-year-old female who suffered 1 year (from 2004/6 to 2005/5) from back pain that radiated to the lower extremities. Fifth lumbar radiculopathy was the first diagnosis. Despite treatment with laser discectomy on 2005/2/15, her pain, lower extremity weakness, and bilateral visual acuity worsened. Three weeks after surgery, she came to our hospital for help and was admitted for evaluation. The diagnosis of neuromyelitis optica was confirmed later. Prednisolone was prescribed and the patient's motor function recovered rapidly but her visual acuity remained poor. The rarity of radicular pain as an initial presentation of neuromyelitis optica might lead to its misdiagnosis and loss of the opportunity for early treatment. However, early diagnosis and treatment are possible through continuous follow-up and complete history taking.