Flower Oliver, Wainwright Mark S, Caulfield Anna Finley
Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia.
Departments of Neurology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Neurocrit Care. 2015 Dec;23 Suppl 2:S23-47. doi: 10.1007/s12028-015-0160-7.
Acute non-traumatic weakness may be life threatening if it involves the respiratory muscles or is associated with autonomic dysfunction. Most patients presenting with acute muscle weakness have a worsening neurological disorder that requires a rapid, systematic evaluation, and detailed neurological exam to localize the disorder. Urgent laboratory tests and neuroimaging are needed in many patients to make the diagnosis. Because acute weakness is a common presenting sign of neurological emergencies, it was chosen as an Emergency Neurological Life Support protocol. Causes of acute non-traumatic weakness are discussed by both presenting clinical signs and anatomical location. For each diagnosis, key features of the history, examination, investigations, and treatment are outlined in the included tables.
急性非创伤性肌无力若累及呼吸肌或伴有自主神经功能障碍,可能会危及生命。大多数急性肌无力患者存在神经系统疾病恶化的情况,这需要进行快速、系统的评估以及详细的神经系统检查来定位该疾病。许多患者需要紧急进行实验室检查和神经影像学检查以明确诊断。由于急性肌无力是神经系统急症的常见表现体征,因此它被选作一项紧急神经生命支持方案。急性非创伤性肌无力的病因将根据临床表现体征和解剖部位进行讨论。对于每种诊断,病史、检查、检查项目及治疗的关键特征在随附表格中列出。