Mahesh Mahadevaiah, Shivanagappa Mamatha, Venkatesh Chilkunda Raviprakash
Associate Professor of Medicine, Department of General Medicine, JSS Medical College, Mysore, Karnataka State, India.
Assistant Professor of OBG, Department of Obstetrics and Gynecology, Medical College, Mysore, Karnataka State, India.
Iran J Med Sci. 2015 Nov;40(6):544-7.
Leptospirosis, a disease of great significance in tropical countries, presents commonly as a biphasic illness with acute febrile episode in the first phase followed by a brief afebrile period and then by the second phase of fever with or without jaundice and renal failure. However, it has varied manifestations and unusual clinical features ascribed to immunological phenomena can occur due to the additional involvement of pulmonary, cardiovascular, and neurological systems. Among the various neurological features, aseptic meningitis is the most common myeloradiculopathy, myelopathy, cerebellar dysfunction, transverse myelitis, Guillain-Barre syndrome, optic neuritis, peripheral neuropathy hare also described. Cranial neuropathy involving facial nerve is a rare, but known neurological manifestation. Sixth nerve palsy in neuroleptospirosis has so far not been reported. We hereby present the occurrence of bilateral abducent nerve palsy in a patient with leptospirosis.
钩端螺旋体病在热带国家是一种具有重大意义的疾病,通常表现为双相性疾病,第一阶段为急性发热期,随后是短暂的无热期,接着进入第二阶段发热,可伴有或不伴有黄疸及肾衰竭。然而,它有多种表现形式,由于肺部、心血管和神经系统的额外受累,可出现归因于免疫现象的不寻常临床特征。在各种神经学特征中,无菌性脑膜炎是最常见的,脊髓神经根病、脊髓病、小脑功能障碍、横贯性脊髓炎、格林-巴利综合征、视神经炎、周围神经病也有描述。累及面神经的颅神经病变是一种罕见但已知的神经学表现。到目前为止,尚未报道神经型钩端螺旋体病中的第六神经麻痹。我们在此报告一例钩端螺旋体病患者出现双侧展神经麻痹的情况。