Trebini F, Appiotti A, Scarzella G
Divisione di Neurologia, Ospedale Mauriziano Umberto I, Torino.
Minerva Med. 1991 Jul-Aug;82(7-8):501-5.
A 19-year-old patient with acute idiopathic polyneuritis is described. Clinically, apart from ophthalmoplegia, areflexia and ataxia, the patient presented a serious bilateral and symmetrical deficiency of the VII-IX-X cranial nerve and hypanapallesthesia of trunk and extremities. Liquor examination showed albumino-cytological dissociation with an increase in liquor IgG; encephalic CT and encephalo-medullary NMR were normal; a neurophysiological study (EMG, PEV, BAER) was indicative of the PNS problems. Combined corticosteroid and plasmaferesis treatment produced complete clinical remission after about 3 months. The primary role of PNS involvement in this clinical entity is discussed.
本文描述了一名19岁的急性特发性多神经炎患者。临床上,除眼肌麻痹、反射消失和共济失调外,患者还出现严重的双侧对称性Ⅶ-Ⅸ-Ⅹ颅神经功能缺损以及躯干和四肢感觉减退。脑脊液检查显示蛋白细胞分离,脑脊液IgG升高;脑部CT和脑脊髓核磁共振成像均正常;神经生理学研究(肌电图、运动神经传导速度、脑干听觉诱发电位)提示周围神经系统问题。联合使用皮质类固醇和血浆置换治疗约3个月后临床完全缓解。文中讨论了周围神经系统受累在这一临床病症中的主要作用。