急性免疫性感觉性多发性神经根病1例报告  

A case report of acute immune sensory polyradiculopathy

作　　者：黎红[1] 樊茉丽[2] LI Hong;FAN Moli(Department of Encephalopathy,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China;不详)

机构地区：[1]潍坊市中医院脑病科,山东潍坊261041 [2]天津医科大学总医院神经内科,天津300052

出　　处：《山东医药》2025年第4期119-122,127,共5页Shandong Medical Journal

摘　　要：目的总结急性免疫性感觉性多发性神经根病(AISP)患者的临床特点,以进一步加深对该病的认识。方法对1例AISP患者的临床表现、体格检查、实验室检查、电生理检查、影像学检查及治疗过程进行回顾性分析。结果患者男,54岁,急性起病,发病前无明显的前驱感染史,发病后病情进展快速,以感觉障碍为主要临床表现,深浅感觉均受累。实验室检查显示,脑脊液呈蛋白-细胞分离,血清抗amphiphysin抗体阳性。肌电图显示,感觉神经传导正常,躯体感觉诱发电位(SEP)异常。患者经静脉注射免疫球蛋白及小剂量激素治疗后,症状明显好转。1年后随访,患者临床症状完全缓解,无复发。结论AISP患者通常急性起病,临床特点包括感觉性共济失调、运动功能正常、腱反射减低或消失、脑脊液蛋白-细胞分离、肌电图传导正常及SEP异常,采用免疫治疗有效,病程为单相性。AISP临床少见,早期识别并开展免疫治疗可显著改善预后。Objective To summarize the clinical features of patients with acute immune sensory polyneuropathy(AISP),in order to further understand the disease.Methods A retrospective analysis was conducted on the clinical presentation,physical examination,laboratory tests,electrophysiological examination,imaging studies,and treatment process of one AISP patient.Results A 54-year-old male patient presented with acute onset,with no obvious history of preceding infection.The condition progressed rapidly,primarily manifested as sensory disturbances,with both superficial and deep sensations affected.Laboratory tests revealed protein-cell dissociation in cerebrospinal fluid and positive anti-amphiphysin antibodies in the serum.Electromyography showed normal sensory nerve conduction,while Somatosensory Evoked Potentials(SEPs)were abnormal.The patient's symptoms significantly improved after receiving intravenous im-munoglobulin and low-dose corticosteroid treatment.One-year follow-up showed complete resolution of symptoms with no recurrence.Conclusions Patients with AISP typically have an acute onset.Clinical features include sensory ataxia,normal motor function,reduced or absent tendon reflexes,cerebrospinal fluid protein-cell dissociation,normal nerve con-duction on electromyography,and abnormal SEP.Immunotherapy is effective,and the disease course is monophasic.AISP is rarely seen in clinical practice,and early recognition and immunotherapy can significantly improve prognosis.

关 键 词：急性免疫性感觉性多发性神经根病 吉兰-巴雷综合征 感觉性共济失调 抗amphiphysin抗体 免疫治疗 

分 类 号：R745[医药卫生—神经病学与精神病学]