Tatsumoto Muneto, Odaka Masaaki, Hirata Koichi, Yuki Nobuhiro
Department of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, 321-0293, Japan.
J Neurol Sci. 2006 Apr 15;243(1-2):35-8. doi: 10.1016/j.jns.2005.11.026. Epub 2006 Jan 5.
The authors reviewed clinical profiles and laboratory findings for 100 cases of abducens nerve paresis without impairment of the other cranial nerves, limb weakness, and ataxia throughout the clinical course. Review of the medical records of 9300 patients referred to our neuoroimmunological laboratory for serum anti-ganglioside antibody testing. Information was obtained from each primary physician on symptoms of preceding infection; initial symptoms; neurological signs during the illness; the clinical course; treatment provided; and outcome. Isolated abducens nerve paresis was present in 100 patients and bilateral paresis in 29. Tentative diagnoses made by the primary physicians on request of anti-ganglioside antibody testing were abducens nerve palsy (n = 68), Fisher syndrome (n = 14), acute ophthalmoparesis without ataxia (n = 14). Symptoms of infection anteceded in 63. Tendon reflexes were absent or decreased in 27. Distal paresthesias were experienced by seven. Serum anti-GQ1b antibody was positive in 25. These findings suggest that some cases of isolated abducens nerve palsy can be categorized as a regional variant of Guillain-Barré syndrome or mild form of Fisher syndrome.
作者回顾了100例展神经麻痹患者的临床资料和实验室检查结果，这些患者在整个临床过程中无其他颅神经损害、肢体无力和共济失调。回顾了9300例转诊至我们神经免疫实验室进行血清抗神经节苷脂抗体检测的患者的病历。从每位首诊医生处获取了关于前驱感染症状、初始症状、患病期间的神经体征、临床过程、所提供的治疗以及预后的信息。100例患者存在孤立性展神经麻痹，29例为双侧麻痹。应抗神经节苷脂抗体检测要求，首诊医生做出的初步诊断为展神经麻痹（n = 68）、费舍尔综合征（n = 14）、无共济失调的急性眼肌麻痹（n = 14）。63例患者有前驱感染症状。27例患者腱反射消失或减弱。7例患者有远端感觉异常。25例患者血清抗GQ1b抗体呈阳性。这些发现表明，一些孤立性展神经麻痹病例可归类为吉兰 - 巴雷综合征的局部变异型或轻度费舍尔综合征。
