We describe the case of a previously well adult presenting with severe neuropathic pain and allodynia as part of an autoimmune brainstem and spinal syndrome with glycine receptor autoantibodies.
Our patient experienced a severe illness, including marked neuropathic pain and allodynia, hypoventilation, tetraparesis, and ophthalmoplegia. A diagnosis of progressive encephalomyelitis with rigidity and myoclonus was made. Neuropathic pain was characterized with validated instruments and responded promptly to cause-directed immunotherapy.
A detailed longitudinal phenotyping, using validated pain measurement instruments, of severe neuropathic pain and allodynia associated with likely pathogenic glycine receptor autoantibodies is reported. This case may have relevance for translational development of analgesics targeting glycinergic neurotransmission.
方法:我们描述了一个先前患有严重神经性疼痛和异常性疼痛的成年人,这是自身免疫性脑干和脊髓综合征的一部分,伴有甘氨酸受体自身抗体。
结果:我们的病人经历了严重的疾病,包括明显的神经性疼痛和异常性疼痛,通气不足,四肢轻瘫,和眼肌麻痹。诊断为进行性脑脊髓炎伴僵硬和肌阵挛症。神经性疼痛用经过验证的仪器进行表征,并迅速对原因导向的免疫疗法作出反应。
结论:详细的纵向表型分析,使用经过验证的疼痛测量仪器,据报道,严重的神经性疼痛和异常性疼痛与可能的致病性甘氨酸受体自身抗体相关。这种情况可能与靶向甘氨酸能神经传递的镇痛药的翻译发展有关。