以极后区综合征为表现的视神经脊髓炎谱系疾病1例

A Case of Neuromyelitis Optica Spectrum Disorder Presenting as Area Postrema Syndrome

摘要: 目的：探讨视神经脊髓炎谱系疾病(Neuromyelitis Optica Spectrum Disorder, NMOSD)的主要临床表现、早期诊断和治疗方法，提高临床医师对NMOSD的认知水平。方法：回顾分析我院1例以极后区综合征(Area Postrema Syndrome, APS)为表现的视神经脊髓炎谱系疾病患者相关病例资料、辅助检查结果及诊疗过程并复习相关文献。结果：患者因“反复呕吐1月余，加重5天”于2023年9月收住于我院，早期使用抑酸护胃等药物治疗后效果欠佳，随后出现视物模糊、右侧肢体乏力等神经系统症状，根据患者临床表现、实验室检查和其他辅助检查结果，最终确诊为NMOSD中的APS，经积极治疗后患者好转出院。结论：NMOSD是一种较为罕见的疾病，临床医师应提高对它的认知，尽可能减少漏诊、误诊，提高NMOSD的早期诊出率。

Abstract: Objective: To explore the main clinical manifestations, early diagnosis, and treatment strategies of Neuromyelitis Optica Spectrum Disorder (NMOSD), aiming to enhance clinicians’ understanding of the disease. Methods: A retrospective analysis was conducted on the case data, auxiliary examination results, and treatment process of a patient diagnosed with NMOSD presenting as Area Postrema Syndrome (APS) admitted to our hospital. Relevant literature was also reviewed. Results: The patient was admitted to our hospital in September, 2023, due to “recurrent vomiting for over a month, worsening for 5 days”. Initial treatment with acid suppression and gastric protection was ineffective. Subsequently, the patient developed neurological symptoms, including blurred vision and right-sided limb weakness. Based on the clinical manifestations, laboratory tests, and auxiliary examination results, the patient was ultimately diagnosed with APS, a subtype of NMOSD. Following active treatment, the patient’s condition improved. Conclusion: NMOSD is a relatively rare disease. Clinicians should increase their awareness of the condition to minimize misdiagnosis and missed diagnosis, thereby improving the early diagnosis rate of NMOSD.