Srivastava Abhishek, Taly A B, Gupta Anupam, Moin Aumir, Murali T
Department of Physical Medicine and Rehabilitation, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, 400 053, Mumbai.
Ann Indian Acad Neurol. 2010 Jan;13(1):67-8. doi: 10.4103/0972-2327.61284.
A 40-year-old man presented with a nonhealing wound on the left ankle for the last 5 weeks, a tingling sensation in both hands for 20 days, and weakness in all four limbs for 10 days. He had been bitten by a snake while working in a sugarcane field 6 weeks earlier and had received tetanus toxoid and anti-snake venom on the day of the bite. He had clinical, biochemical, and electrophysiological features of Guillain-Barré syndrome, with motor and sensory neuropathy-primarily suggestive of demyelination with secondary axonal degeneration. Recognition of this unusual complication following snake bite or use of anti-snake venom / tetanus toxoid has considerable epidemiological, therapeutic, and prognostic significance.
一名40岁男性，左侧脚踝有一伤口持续不愈合达5周，双手有刺痛感20天，四肢无力10天。6周前他在甘蔗田工作时被蛇咬伤，咬伤当天接受了破伤风类毒素和抗蛇毒血清治疗。他具有吉兰 - 巴雷综合征的临床、生化及电生理特征，表现为运动和感觉神经病变，主要提示脱髓鞘伴继发性轴索变性。认识到蛇咬伤或使用抗蛇毒血清/破伤风类毒素后出现的这种不寻常并发症具有重要的流行病学、治疗及预后意义。
