Nagashima Takahide, Odaka Masaaki, Koga Michiaki, Yuki Nobuhiro, Hirata Koichi
Department of Neurology, Dokkyo University School of Medicine.
Rinsho Shinkeigaku. 2002 Jun;42(6):523-6.
A 68-year-old man without history of antecedent infection experienced nasal voice (day 1), and the developed dysphagia on day 9. Eleven days after the onset, he developed ophthalmoplegia, and on day 13 mild weakness in the neck and the upper limbs. Cerebrospinal fluid examination revealed albuminocytologic dissociation on day 19. Motor nerve conduction velocities and compound muscle action potentials were normal, but terminal latency was slightly prolonged in the median nerve. Enzyme-linked immunosorbent assay showed that the patient's anti-GT1 a IgG antibody fiter was high and that the antibody cross-reacts with GQ1b. We considered that this patient showed acute oropharyngeal palsy at the onset, and then evolved into pharyngeal-cervical-brachial weakness. The presence of this case suggested the nosological continuity between acute oropharyngeal palsy and pharyngeal-cervical-brachial weakness in both clinical and serological aspects.
一名68岁男性，无前驱感染史，第1天出现鼻音，第9天出现吞咽困难。起病11天后出现眼肌麻痹，第13天颈部和上肢出现轻度无力。第19天脑脊液检查显示蛋白细胞分离。运动神经传导速度和复合肌肉动作电位正常，但正中神经的终末潜伏期略有延长。酶联免疫吸附试验显示该患者抗GT1 a IgG抗体滴度高，且该抗体与GQ1b交叉反应。我们认为该患者起病时表现为急性口咽麻痹，随后发展为咽-颈-臂肌无力。该病例的存在提示急性口咽麻痹与咽-颈-臂肌无力在临床和血清学方面均存在疾病学连续性。
