Bajaj B K, Shrestha S
Neurology Division, Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Neurol India. 2007 Jan-Mar;55(1):67-9. doi: 10.4103/0028-3886.30432.
The French physician Augustine Marie Morvan first used the term 'la choriotae fibrillare' to describe a syndrome characterized by peripheral nerve hyperexcitability, dysautonomia, insomnia and fluctuating delirium. There are no published reports of the condition from the Indian subcontinent. We report the first such case from the region. Our patient, a 24-year-old male, presented with easy fatigability and stiffness in both the calves for 18 months; continuous twitching of muscles of all four limbs and jaw for two months; hyperhydrosis, palpitations, urinary symptoms, burning dysesthesia in hands, insomnia and abnormal sleep behavior for about a month. Patient had bilateral hyper-reflexia with extensor plantar on the right and equivocal response on the left. Electromyography revealed continuous muscle fiber activity. Thyroid function test, electroencephalography, computerized tomography scan (head) and routine cerebrospinal fluid analysis were normal. The patient showed marked clinical and electrophysiological improvement on prednisolone along with symptomatic therapy over the next two months.
法国医生奥古斯丁·玛丽·莫尔万首次使用“la choriotae fibrillare”一词来描述一种以周围神经兴奋性增高、自主神经功能障碍、失眠和波动性谵妄为特征的综合征。印度次大陆尚无关于该病症的已发表报告。我们报告了该地区的首例此类病例。我们的患者是一名24岁男性,双小腿出现易疲劳和僵硬症状18个月;四肢和下颌肌肉持续抽搐2个月;多汗、心悸、泌尿系统症状、手部烧灼样感觉异常、失眠及异常睡眠行为约1个月。患者双侧腱反射亢进,右侧巴氏征阳性,左侧反应不明确。肌电图显示肌肉纤维持续活动。甲状腺功能检查、脑电图、计算机断层扫描(头部)及常规脑脊液分析均正常。在接下来的两个月里,患者在接受泼尼松龙治疗及对症治疗后,临床和电生理方面均有明显改善。