Sugie Miho, Ando Noriaki, Ueno Satoshi
Department of Neurology, National Hospital Organization Nara Medical Center.
Rinsho Shinkeigaku. 2006 Apr;46(4):297-300.
A 47-year-old man who presented moderate muscle weakness in the neck and all the extremities was diagnosed as having early stage of amyotrophic lateral sclerosis (ALS). He did not have bulbar dysfunction and respiratory distress. His pulmonary function tests and arterial blood gas analysis showed no abnormalities, but polysomnography (PSG) revealed sleep-disordered breathing requiring mechanical support ventilation. Bi-level positive airway pressure treatment was started only at night, which improved both sleep-disordered breathing and daytime activity. PSG should be considered in ALS patients at an early clinical stage in order to predict mild respiratory dysfunction.
一名47岁男性,颈部和四肢出现中度肌无力,被诊断为肌萎缩侧索硬化症(ALS)早期。他没有延髓功能障碍和呼吸窘迫。其肺功能测试和动脉血气分析均无异常,但多导睡眠图(PSG)显示存在睡眠呼吸障碍,需要机械辅助通气。仅在夜间开始采用双水平气道正压通气治疗,这改善了睡眠呼吸障碍和日间活动。对于处于临床早期的ALS患者,应考虑进行PSG检查,以预测轻度呼吸功能障碍。