Quinlan C S, Walsh J C, Moran A-M, Moran C, O'Rourke S K
Department of Orthopaedic Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
J Bone Joint Surg Br. 2011 Feb;93(2):266-8. doi: 10.1302/0301-620X.93B2.25700.
We describe a case of bilateral weakness of the lower limbs, sensory disturbance and intermittent urinary incontinence, secondary to untreated Gitelman's syndrome, in a 42-year-old female who was referred with presumed cauda equina syndrome. On examination, the power of both legs was uniformly reduced, and the perianal and lower-limb sensation was altered. However, MRI of the lumbar spine was normal. Measurements of serum and urinary potassium were low and blood gas analysis revealed metabolic alkalosis. Her symptoms resolved following potassium replacement. We emphasise the importance of measurement of the plasma and urinary levels of electrolytes in the investigation of patients with paralysis of the lower limbs and suggest that they, together with blood gas analysis, allow the exclusion of unusual causes of muscle weakness resulting from metabolic disorders such as metabolic alkalosis.
我们描述了一例42岁女性患者，因未治疗的吉特曼综合征继发双侧下肢无力、感觉障碍和间歇性尿失禁，该患者因疑似马尾综合征转诊。检查发现双腿肌力均一致减弱，肛周及下肢感觉改变。然而，腰椎MRI检查正常。血清和尿钾测量值偏低，血气分析显示代谢性碱中毒。补钾后她的症状得到缓解。我们强调在对下肢瘫痪患者进行检查时测量血浆和尿电解质水平的重要性，并建议它们与血气分析一起，有助于排除代谢性疾病如代谢性碱中毒导致肌肉无力的不寻常原因。
