疑似吉兰-巴雷综合征的脊髓损伤患者1例报告  

Spinal cord injury with suspected Guillain-Barre syndrome:a case report

作　　者：王晓斌 王芳[2] Wang XiaoBin;Wang Fang(Department of Neurology,Baotou Central Hospital,Baotou City,Inner Mongolia Autonomous Region,014040,China;Department of Oncology Surgery,Baotou Central Hospital,Baotou City,Inner Mongolia Autonomous Region,014040,China)

机构地区：[1]包头市中心医院神经内科,内蒙古自治区包头市014040 [2]包头市中心医院肿瘤外科,内蒙古自治区包头市014040

出　　处：《现代电生理学杂志》2023年第3期179-181,共3页Journal of Modern Electrophysiology

摘　　要：患者主诉“四肢无力16小时”,无前驱感染及明确外伤史。专科查体:四肢呈对称性迟缓性瘫痪,Hughes评分4分,结合头颅CT及实验室检查,拟诊为吉兰-巴雷综合征。神经电生理检测发现F波出现率低,甚至未引出肯定波形,四肢运动神经传导却正常,这与F波异常不相匹配。对于症状较轻的吉兰-巴雷综合征患者,在发病早期,运动神经传导结果可能正常;该患者更倾向于较重亚型-急性运动轴索性神经病,发病早期随着F波异常的出现,运动神经传导也应当出现异常。如两者不匹配,需引起重视。The male patient was admitted to the hospital for weakness of limbs for 16 hours,without a history of prodromal infection or definite trauma.Physical examination showed symmetrical flaccid paralysis of limbs,with Hughes score of 4.Head CT and laboratory examination were performed on admission,and myelopathy and skeletal muscle ion channel disease were preliminarily excluded.The patients was suspected to be Guillain-Barre syndrome.In neuroelectrophysiological examination,it was found that the occurrence rate of F wave was low or even no positive wave was elicited,but there was no abnormality in motor nerve conduction of limbs,that is,the motor nerve conduction did not match with F wave,which was not consistent with the diagnostic criteria of Guillain-Barre syndrome.Analysis,the onset of acute stage,axonal damage did not reach the peak,there may be normal detection,but literature review and clinical practice,for Guillain-Barre syndrome,especially acute motor axonal neuropathy,symptoms are more severe in this subtype,early F wave abnormalities,motor nerve conduction also appear abnormal,if the two do not match,we should pay attention to,broaden the diagnosis.The final diagnosis is also a good illustration of this point.

关 键 词：电生理学 神经传导 吉兰-巴雷综合征 脊髓损伤 F波 

分 类 号：R745.43[医药卫生—神经病学与精神病学]