多发脑神经受累的抗sulfatide抗体阳性吉兰-巴雷综合征变异型1例  

A variant of Guillain Barre syndrome with positive anti sulfatide antibody in multiple cranial nerve involvement:a case report

作　　者：王库良 莫金祖 卢韬 阳洪[1] WANG Kuliang;MO Jinzu;LU Tao;YANG Hong(Department of Neurology,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545000)

机构地区：[1]广西医科大学附属第四医院神经内科,柳州545000

出　　处：《中国神经精神疾病杂志》2022年第3期159-161,共3页Chinese Journal of Nervous and Mental Diseases

基　　金：广西柳州市科技局科技重大项目(编号:2020NBAB0824);广西柳州市科技局科技重大项目(编号:2020NBAB0809);广西自然科学基金委员会面上项目(编号:2019GXNSFAA185048);广西医科大学青年基金项目(编号:GXMUYSF201931);。

摘　　要：报告了1例55岁男性患者,以头晕,头痛起病,病情进展后出现视物重影,行走不稳,吞咽困难,言语不清,同时伴有头面部、全身及四肢麻木不适,体格检查发现双眼球固定,构音不清,咽反射减弱,双下肢跟膝胫试验不准,四肢腱反射未引出,病理征未引出。腰椎穿刺检查脑脊液提示蛋白-细胞分离,抗sulfatide抗体阳性,结合电生理及其他辅助检查考虑吉兰-巴雷综合征(Guillain Barre syndrome,GBS)变异型,予以免疫球蛋白冲击治疗后好转出院。本病例与以往报告的抗sulfatide抗体阳性的GBS临床表现存在较大差异,国内仅见少量个案报告,临床上往往难以识别,通过该病例的临床诊治过程分析及相关文献复习,提高对此类疾病诊治的认识。This case reports a 55 year old male patient who initially presented with dizziness and headache.He then experienced double vision,acataposis,dysarthria,pronounced ataxia and a tingling sensation at the head and extremities with the illness deterioration.Physical examination showed that the eyeballs were fixed,the articulation was unclear,the pharyngeal reflex was weakened,the heel knee tibial test of both lower limbs was inaccurate,the tendon reflexs of the limbs were not elicited,and the pathological signs were not elicited.Lumbar puncture examination of cerebrospinal fluid showed protein cell separation and positive anti sulfatide antibody.The patient was diagonsed the variant of Guillain Barre syndrome(GBS)in combination with electrophysiological and other auxiliary examinations.The patient was improved and discharged after immunoglobulin therapy.This case was quite different from the clinical manifestations of GBS with positive anti sulfatide antibody reported in the past.There were only a few cases reported in China,which are often difficult to identify clinically.Through the analysis of the clinical diagnosis and treatment process of this case and the review of relevant literature,we can improve our understanding of the diagnosis and treatment of this kind of disease.

关 键 词：sulfatide抗体阳性 多发脑神经受累 吉兰-巴雷综合征变异型 

分 类 号：R744.5[医药卫生—神经病学与精神病学] R745.1[医药卫生—临床医学]