神经痛性肌萎缩a7662888战友a3year-oldmanwithapast.doc

神经痛性肌萎缩A7662888战友： A 35-year-old man with a past history of Crohns disease complained of both shoulder pain and winging of the right scapula for 2 weeks. What is your diagnosis? Liusuifeng战友： 只有翼状肩胛啊??又犯难了??1左侧胸长神经麻痹？原因？难不成是颈总动脉或锁骨下动脉动脉瘤？ 颈肋综合症？和克隆病有没有关系？难道是肉芽肿选择性倾犯胸长神经？（呵呵?? 瞎说了??可能性不大吧）??2左侧前锯肌瘫痪?? 面肱肩性肌营养不良？??只有翼状肩胛啊??面肌????上臂肌群都不受累么？??难啊??准备听讲吧?? 定位诊断：双侧颈部神经根、臂丛神经定性诊断：免疫介导性颈神经根神经丛神经病?????????? Crohn病??????????炎性肠病併发神经系统损害Neurological dysfunction in inflammatory bowel disease 炎性肠病主要包括溃疡性结肠炎和克隆氏病。Inflammatory bowel diseases mainly include ulcerative colitis(UC) and Crohn’s disease(CrD).、周围神经系统??peripheral nervous system?? 1.轴索性感觉运动神经病??axonal sensorimotor neuropathy?? 2.急性炎性脱髓鞘性多发性神经病(格林巴利综合征) Acute inflammatory demyelinating polyneuropathy ??(Guillain-Barre syndrome)?? 3.单神经病??mononeuropathy?? 4.臂丛神经病??brachial plexopathy?? 5.多发性单神经病??mononeuritis multiplex?? 6.多发性嵌压神经病??multiple compressive neuropathies?? 7.颅神经病??cranial neuropathies?? 8.急性感音性听力丧失??Acute sensorineural hearing loss?? 9.Melkersson-Rosenthal综合征??Melkersson-Rosenthal syndrome、肌肉和神经肌肉接头 muscle and myoneural junction1.皮肌炎 dermatomyositis2.多发性肌炎 polymyositis 3.镶边空泡肌病 rimmed vacuole myopathy4.肉芽肿性肌炎 granulomatous myositis5.重症肌无力??myasthenia gravis、中枢神经系统（抗心磷脂抗体、同型半胱氨酸、促血小板生成素）central nervous system (anticardiolipin antibodies,homocysteine,thrombopoietin level)1.脑血管疾病 cerebrovascular disease??脑血管炎 cerebral vasculitis??皮层静脉和硬膜窦血栓形成 dural and cortical venous thrombosis??肺栓子继发脑栓塞 cerebral embolism secondary to pulmonary embolus??动脉血栓栓塞性梗塞??arterial thromboembolic infarction2.脊髓病??myelopathic disease??慢性缓慢进展性脊髓病 chronic slowly progressive myelopathy??多发性硬化 multiple sclerosis??横贯性脊髓炎 transverse myelitis??脊髓积脓??Spinal empyema3.癫痫 seizures4.弥漫性脑病 diffuse encephalopathy5.营养缺乏 nutritional deficiency??韦尼克脑病 Wernicke encephalopathy??硒诱导性脑病??selenium-induced encephalopathyA7662888战友： 大家好像忽略Pain了，再仔细看看图片喔！别想太复杂了！ 再猜一下：1带状疱疹病毒感染?? 神经痛性肌萎缩 AYes, you got it!But still one