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单卵孪生同胞以中枢神经系统受累为临床表现的类肉瘤病以前无报告。本文报告一对症状与病程相同并迅速缓解的病例。单卵孪生姐妹,27岁。姐姐于1975年6月患结节性红斑。6周后左侧面神经麻痹。3周后因前额剧痛、视力模糊、间歇性水平复视和眩晕而住院。检查发现双侧视乳头水肿,右侧眼外直肌麻痹及轻度左侧面神经麻痹。淋巴结未触及。胸部及颅骨X光照片、同位素脑扫描正常。入院时血沉58mm/时,3天后血沉73mm/时,各种血液学检查正常。脑电图双侧慢波,右侧尤为明显。右侧颈内动脉血管造影显示颈内动脉循环减慢,符合颅内高压,但无其他异常。气脑造影正常。脑脊液检查,淋巴细胞1/mm~3,蛋白0.7g/L,葡萄糖2.8mmol/L。以强的松每天40mg治疗1个月。颅神经麻痹和视乳头水肿缓解。
Single sibling twin siblings with central nervous system involvement as a clinical manifestation of sarcoidosis have not previously been reported. This article reports a case of the same symptoms and the same course of disease and rapid relief. Single egg twin sisters, 27 years old. My sister suffered from nodular erythema in June 1975. Left facial paralysis 6 weeks later. Three weeks later hospitalized for severe forehead pain, blurred vision, intermittent diplopia and dizziness. Examination revealed bilateral papilledema, right lateral lateral palsy and mild left facial paralysis. Lymph nodes not touched. Chest and skull X-ray, isotope brain scan normal. Erythrocyte sedimentation rate 58mm / hour, 3 days after erythrocyte sedimentation rate 73mm /, all kinds of hematology examination was normal. EEG bilateral slow wave, the right is particularly obvious. Right internal carotid artery angiography showed slowing of the internal carotid artery, in line with intracranial hypertension, but no other abnormalities. Cerebral angiography is normal. Cerebrospinal fluid examination, lymphocyte 1 / mm ~ 3, protein 0.7g / L, glucose 2.8mmol / L. Treatment with prednisone 40mg daily for 1 month. Cranial nerve paralysis and papilloma edema relief.