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Rehabilitation Practice and Science

Translated Title

類風濕性關節炎之頸椎不完全脫位術後併發股神經及閉孔神經病變：病例報告

Abstract

Rheumatoid arthritis is a chronic inflammatory disease. Although it primarily affects joints, systemic involvement is frequent. Lung, skin, blood, cardiovascular system and nerve are often affected. Indeed, involvement of the peripheral nervous system may occur with a variety of clinical patterns.A 67-year-old woman suffered from rheumatoid arthritis for 10 years with regular medical control. Due to bilateral distal parts of hands and feet numbness, and gait disturbance for about 2 months, she was diagnosed of rheumatoid arthritis with C1-C2 subluxation by neurosurgeon. C1-C2 posterior spinal fusion was performed. But, the patient felt left lower extremity weaker than right one then. The muscle strength of left knee extension and thigh adduction was poor and hip flexion was good. Paresthesia was found over left anterior medial thigh and hypesthesia was found over distal part of four limbs. Electrodiagnosis showed severe left femoral and obturator neuropathy and mild peripheral sensory neuropathy. Pelvic CT scan showed no hematoma nor tumor. After rehabilitation, the patient could ambulate independently for 15 meters without device and with a regular cane for longer distance. Rheumatoid arthritis with peripheral neuropathy have been documented in the medical literatures, except femoral neuropathy together with obturator neuropathy. This casereport aims at reminding the clinician how to prevent complication of compressive neuropathy.

Language

Traditional Chinese

First Page

113

Last Page

117

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