Perlick L, Möller G, Wallny T, Schmitt O
Klinik und Poliklinik für Orthopädie, Rheinische Friedrich-Wilhelms-Universität, Bonn.
Z Orthop Ihre Grenzgeb. 1999 Nov-Dec;137(6):503-7. doi: 10.1055/s-2008-1039379.
Diagnosis of Guillian-Barré Syndrome usually is not difficult, but diagnostic failure occurs for the variable initial presentation. Diagnosis is based on physical examination showing loss of motor strength in more than one limb and loss of deep tendon reflexes. Ventilatory assistance, pharmacologic maintenance of cardiovascular homeostasis, corticosteroids, IgG and plasma exchange are the dominant therapeutic measures.
This article reports on a case of a 59-year old surgeon suffering from degenerative disc disease in the lumbar spine. The patient developed a severe course of the Guillian-Barré Syndrome with persisting motor weakness of the legs.
If the primary problem at presentation is limb and back pain the pathology appears to be in the musculoskeletal rather than in neurological system. The awareness of this presentation of Guillian-Barré-Syndrome will eliminate delay in diagnosis.
吉兰-巴雷综合征的诊断通常并不困难,但由于初始表现多样,仍会出现诊断失败的情况。诊断依据体格检查,表现为多肢体肌力丧失和深腱反射消失。通气支持、维持心血管稳态的药物治疗、皮质类固醇、免疫球蛋白G和血浆置换是主要治疗措施。
本文报告一例59岁患有腰椎退行性椎间盘疾病的外科医生。该患者患严重吉兰-巴雷综合征,腿部运动无力持续存在。
如果就诊时的主要问题是肢体和背部疼痛,病理似乎存在于肌肉骨骼系统而非神经系统。认识到吉兰-巴雷综合征的这种表现将消除诊断延误。