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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Priv.-Doz. Dr. med. F. Grahmann
Klinik für Neurologie
Knappschaftskrankenhaus
Wieckesweg 27
44309 Dortmund
Email: Friedrich.Grahmann@kk-dortmund.de
