Seneviratne U, Gunasekera S
Department of Neurology, Ratnapura General Hospital, Ratnapura, Sri Lanka Institute of Neurology, National Hospital of Sri Lanka, Colombo 8, Sri Lanka.
J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):540-2. doi: 10.1136/jnnp.72.4.540.
Six patients who presented with acute sensory neuropathy were studied. All patients underwent detailed clinical assessment along with electrophysiological tests and relevant laboratory investigations. All patients had acute onset numbness, reaching the peak deficit within 4 weeks. Four of them had associated burning dysaesthesia. An antecedent illness was reported in four; diarrhoea in three, and urinary tract infection in one. The neurological examination disclosed normal muscle strength, symmetric glove and stocking type sensory loss for pain and temperature, normal proprioception, and vibration senses with normal or brisk tendon reflexes. Analysis of CSF demonstrated albuminocytological dissociation in all. Routine motor and sensory nerve conduction studies were normal. Sympathetic skin responses were also normal except for the lower limbs in one patient. Stool cultures for Campylobacter jejuni were negative. The outcome was favourable. Burning dysaesthesia disappeared within 4 months. Numbness and objective sensory loss tended to persist longer. The clinical features and normal routine nerve conduction studies, which assess large diameter nerve fibre function, indicate small sensory fibre dysfunction in the group. Their presentation and CSF findings would fit into the diagnosis of sensory Guillain-Barré syndrome. The current study suggests that acute small fibre sensory neuropathy (ASFSN) is another clinical entity which could perhaps be included in the heterogeneous range of Guillain-Barré syndrome.
对6例急性感觉性神经病患者进行了研究。所有患者均接受了详细的临床评估以及电生理检查和相关实验室检查。所有患者均急性起病，出现麻木症状，在4周内达到最大功能缺损。其中4例伴有烧灼样感觉异常。4例患者报告有前驱疾病；3例腹泻，1例尿路感染。神经系统检查显示肌力正常，疼痛和温度觉呈对称的手套袜套样感觉丧失，本体感觉正常，振动觉正常，腱反射正常或活跃。脑脊液分析显示所有患者均有蛋白细胞分离现象。常规运动和感觉神经传导研究正常。除1例患者下肢外，交感神经皮肤反应也正常。空肠弯曲菌粪便培养阴性。预后良好。烧灼样感觉异常在4个月内消失。麻木和客观感觉丧失往往持续时间更长。临床特征以及评估大直径神经纤维功能的常规神经传导研究正常，表明该组患者存在小感觉纤维功能障碍。他们的临床表现和脑脊液检查结果符合感觉性吉兰-巴雷综合征的诊断。目前的研究表明，急性小纤维感觉神经病（ASFSN）可能是另一种临床实体，或许可以纳入吉兰-巴雷综合征的异质性范畴。
