Fletcher-Peddie K, Alfred R, Penn-Brown K, Gayle F, Gilbert D T, Elliot V, Ferguson T S
Department of Medicine, University Hospital of the West Indies, Kingston 7, Jamaica.
Scarborough General Hospital, Signal Hill, Tobago.
West Indian Med J. 2013 Sep;62(7):658-66. doi: 10.7727/wimj.2013.039.
This paper reports a case of a Jamaican young woman who experienced flaccid quadriparesis and bulbar weakness over a three-week period after a gastrointestinal illness. Nerve conduction studies confirmed an axonal type neuropathy consistent with the acute motor-sensory axonal neuropathy variant of the Guillain-Barré syndrome. Recovery, although evident, was slow and was augmented after a course of intravenous immunoglobulin. The patient was discharged from hospital after three months but was re-admitted one week later and eventually succumbed to complications of the illness. This case serves as a reminder that Guillain-Barré syndrome is now the most common cause of acute flaccid paralysis and should be considered early in all patients presenting with flaccid quadriparesis.
本文报告了一例牙买加年轻女性病例,该患者在患胃肠疾病三周后出现弛缓性四肢瘫和延髓肌无力。神经传导研究证实为轴索性神经病,符合吉兰 - 巴雷综合征急性运动感觉轴索性神经病变异型。尽管恢复明显,但过程缓慢,静脉注射免疫球蛋白治疗一个疗程后恢复有所加快。患者三个月后出院,但一周后再次入院,最终死于该疾病的并发症。该病例提醒我们,吉兰 - 巴雷综合征现已成为急性弛缓性麻痹最常见的病因,对于所有出现弛缓性四肢瘫的患者都应尽早考虑该病。