J Korean Neurol Assoc > Volume 21(2); 2003 > Article

Journal of the Korean Neurological Association 2003;21(2): 141-145.

수족구 증후군의 임상 양상 및 자기공명혈관조영술 소견

문창종 , 이재진 김후원 정원영

조선대학교 의과대학 신경과학교실

"Clincal, MRI and MRA Findings of Cheiro-Oral-Pedal syndrome"

Chang Jong Moon

Department of Neurology, Chosun University Medical College

Abstract

"Background : Cheiro-oral-pedal syndrome is characterized by a unilateral or bilateral sensory disturbance in mouth corner and hand and/or foot, and associated with central nervous system disease. Causative diseases are cerebral infarc-tion, intracranial hemorrhage, brain tumor, migraine, etc. When related with cerebral infarction, it is known to have lacunar type pathology and favorable prognosis. But other pathogenic mechanism and poor prognosis is suggested. Methods : We retrospectively studied 12 patients presented with cheiro-oral-pedal syndrome, who visited the depart-ment of neurology in Chosun University Hospital from September 2000 to August 2002. Cheiro-oral-pedal syndrome was diagnosed according to the clinical manifestations and brain MRI findings. We assessed neurological findings, brain MRI and MRA findings, duplex sonographic findings, risk factors of stroke and outcome of the patients. Follow-up period was 3-20 (mean 8) months. Results : There were 12 patients (10 men, 2 women) with the age ranged from 45 to 80 (mean 57.8) years. Sensory loss on cheiro-oral area was present in 8 (66.7%) and on cheiro-oral-pedal area in 4 (33.3%). Responsible lesions were found in thalamus , capsulo-striatum, corona radiata, pons, and fronto-parietal cor-tex. Three patients had a major cerebral vascular abnormality on MRA. One had MCA stenosis, the other PCA stenosis and another distal ICA stenosis. Sensory symptoms had remained in all patient except one. In-hospital mortality and other neurological deficit at discharge were absent in all. Conclusions : Cheiro-oral syndrome has mixed pathogenic mechanism of small vessel disease and large vessel atherosclerosis and involves various sites. Paresthesia itself has bad prognosis but overall clinical course is benign.Key Words : Cheiro-oral, Cerebral infarction, Lacune"