Hayashi Ryuichiro, Yamaguchi Shigeki
Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan.
Intern Med. 2015;54(3):345-7. doi: 10.2169/internalmedicine.54.2972.
We herein report the case of a 19-year-old woman with facial diplegia and paresthesias (FDP) preceded by flu-like symptoms. We diagnosed the patient with a regional variant of Guillain-Barré syndrome due to decreased tendon reflexes, albuminocytological dissociation in the cerebrospinal fluid and demyelinating features on nerve conduction studies. The patient also had IgM anti-GalNAc-GD1a antibodies, and treatment with glucocorticoids was effective for treating the facial diplegia, but not paresthesia. Therefore, facial palsy may have a different pathophysiology from paresthesia or other symptoms of FDP, which responds to glucocorticoid therapy.
我们在此报告一例19岁女性病例，该患者在出现类似流感症状后出现面部麻痹和感觉异常（FDP）。由于腱反射减弱、脑脊液中蛋白细胞分离以及神经传导研究显示脱髓鞘特征，我们将该患者诊断为格林-巴利综合征的一种区域性变异型。该患者还存在IgM抗GalNAc-GD1a抗体，糖皮质激素治疗对面部麻痹有效，但对感觉异常无效。因此，面瘫可能与感觉异常或FDP的其他症状具有不同的病理生理学机制，后者对糖皮质激素治疗有反应。
