Paraneoplastische sensible Polyneuropathie Denny-Brown mit nicht organischer Tetraparese

Zusammenfassung

Wir berichten den Fall einer 44 Jahre alten Patientin mit einer psychiatrischen äthylischen und medikamentösen Suchtanamnese, Depression, Angsterkrankung und einem polyneuropathischen Syndrom mit progredienter Gangstörung. Die motorische Funktionsstörung entwickelte sich rasch zu einer hochgradigen schlaffen Tetraparese, für die sich aber keine objektiven klinischen und neurophysiologischen Befunde fanden. Sie wurde daher als psychogen eingeordnet und es wurde eine stationäre psychiatrische Behandlung begonnen. Erst in einer zweiten neurologischen Untersuchung wurde die Diagnose „sensible Polyneuropathie paraneoplastischer Genese und psychogene Tetraparese” gestellt. Es wurde ein Mammakarzinom entdeckt und im Weiteren operiert und nachbestrahlt. Die Negativität der Anti-Hu-, Anti-Jo- und Anti-Ri-Antikörper im Liquor cerebrospinalis schließt diese Diagnose nicht aus.

Abstract

We report on the case of a 44-year-old female patient with a history psychiatric alcohol and drug addiction, depression, motor function disorder and a polyneuropathic syndrome with progressive gait disorder. The motor functional disorder rapidly developed to a high-degree limp paresis, for which there were no objective clinical or neurophysiological causes. It was thus classified as psychogenic and inpatient psychiatric treatment was initiated. Only in a second neurological examination was the diagnosis of a „sensory polyneuropathy of paraneoplastic origin and psychogenic tetraparesis” made. Carcinoma of the breast was discovered and then treated surgically with subsequent radiotherapy. The negative findings of anti-Hu, anti-Jo and anti-Ri antibodies in the cerebrospinal fluid could not exclude this diagnosis.

Schlüsselwörter

paraneoplastische sensible Polyneuropathie - Denny-Brown-Syndrom - antineuronale Antikörper

Keywords

paraneoplastic sensory polyneuropathy - Denny-Brown syndrome - anti-neuronal antibodies

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