Patzold U, Haller P
Dtsch Med Wochenschr. 1975 Mar 7;100(10):477-9. doi: 10.1055/s-0028-1106241.
In a 59-year-old man in complete health a pure motor polyneuropathic syndrome with quadruplegia, swallowing and respiratory paralysis developed over a few hours. A few days later he died with the clinical picture of septicaemia. In a 59-year-old woman who had been investigated and treated for a suspected carcinoma for several months a predominantly distal sensomotoric polyneuropathy syndrome developed. The further course of disease was completely misleading as regards the diagnosis due to an acutely occurring transection syndrome with flaccid paraplegia, loss of reflexes, and bladder and rectal paralysis. Due to the very unusual neurological symptoms panarteritis nodosa was only diagnosed at autopsy and by histology in both cases. Panarteritis nodosa must be considered as a differential diagnosis in Landry-type polyneuropathy as well as in an acute spinal transection syndrome. The first patient demonstrates toxic damages, the second vascular damages of the nervous system which in general determine the neurological symptomatology of this vascular disease.
一名59岁身体健康的男性在数小时内出现了伴有四肢瘫痪、吞咽和呼吸麻痹的纯运动性多神经病变综合征。几天后,他因败血症的临床表现而死亡。一名59岁的女性,因疑似癌症接受了数月的检查和治疗,出现了以远端为主的感觉运动性多神经病变综合征。由于急性发生的横断综合征伴弛缓性截瘫、反射消失以及膀胱和直肠麻痹,疾病的进一步发展在诊断方面极具误导性。由于非常不寻常的神经症状,两例均仅在尸检和组织学检查时才诊断出结节性多动脉炎。结节性多动脉炎在Landry型多神经病变以及急性脊髓横断综合征中都必须被视为鉴别诊断。第一例患者表现为中毒性损害,第二例为神经系统的血管性损害,总体上决定了这种血管疾病的神经症状学表现。