急性炎性脱髓鞘性多发性神经病四例诊疗体会  

Atyptical Guillain-Barre Syndrome case analysis(attaches 4 example reports)

作　　者：尹汝尊[1] 马太成[1] 杨潮萍[2] 郭书英[3] 

机构地区：[1]肃宁县人民医院,河北062350 [2]河北省沧州市中心医院 [3]河北医科大学第二医院神经内科

出　　处：《脑与神经疾病杂志》2009年第3期210-213,共4页Journal of Brain and Nervous Diseases

摘　　要：目的报告我科收治的临床少见的4例急性炎性脱髓鞘性多发性神经病(AIDP)患者。方法1例疑似肉毒中毒的临床表现,1例以颅内压增高为首发症状,1例为疑似脊髓横贯性损伤,1例以小脑性共济失调为首发症状,住院后,出现四肢软瘫、临床检测肌电图呈神经源性受损,脑脊液有蛋白-细胞分离现象、采用激素及营养神经治疗病情好转。结果作者体会AIDP可以有颅神经、脊髓和小脑损害、高颅压的首发症状,但动态观察仍以运动损害较重,颅神经运动根的选择性损害,主观感觉障碍重于客观感觉障碍,脑脊液的蛋白-细胞分离现象,肌电图神经源性损害,相对良好的预后等特点。结论在临床实践中应注意与其他疾病鉴别。Objective The report is about four rare cases of acute inflammatory emyelinating polyneuropathy AIDP） in our department. Methods 1 case is suspected the same as botulism, 1 case intracranial hypertension as the first symptom, 1 case is suspected as transverse spinal cord injury, and the other cerebella ataxia as the first symptom. After admission, flaccid paralysis of limbs appeared; EMG showed neurogenic damage; CSF test showed protein-cell separation. When hormone and nerve nutrition therapy were given, the condition of the patients became better. Results The authors thought the first symptom of AIDP can be cranial nerves, spinal cord and cerebellum damage, but AIDP was characterized by motor injury more serious, selective damage of cranial nerve motor roots., subjective sensory disturbance more serious than objective sensory disturbance, protein-cell separation phenomenon in the CSF, EMG showing neurogenic damage, relatively better prognosis and so on from dynamic observation. Conclusion Pay attention to identify it from other diseases.

关 键 词：急性炎性脱髓鞘性多发性神经病 肉毒中毒 颅高压 脊髓病变 后颅窝病变 

分 类 号：R745.43[医药卫生—神经病学与精神病学]