Takayoshi Hiroyuki, Nakadera Yukie, Nakagawa Tomonori, Kadota Katsuhiko, Abe Satoshi, Mitaki Shingo, Yamaguchi Shuhei
Department of Neurology, Shimane University Hospital.
Nihon Ronen Igakkai Zasshi. 2015;52(4):425-8. doi: 10.3143/geriatrics.52.425.
We herein describe the case of a 90-year-old man. He had been treated for type II diabetes mellitus for over twenty years. One day he noticed weakness in the bilateral upper limbs. The next morning the symptoms extended to the bilateral lower limbs. As a result, he was admitted to Shimane University Hospital. MRI showed mild compression of the cervical spinal cord, but it did not account for his neurological symptoms. Because his quadriplegia progressed, we examined the cerebrospinal fluid with albuminocytologic dissociation. A nerve conduction study showed an axonal neuropathy pattern. We diagnosed Guillain-Barre syndrome and started intravenous immunoglobulin (IVIg) therapy 5 mg/kg on the fifth day after admission. All deep tendon reflexes were absent during the treatment. He was able to get up one week later and could walk by himself two weeks later. Guillain-Barre syndrome is a treatable disease and this disorder should be taken into consideration even if an elderly person presents with quadriplegia.
我们在此描述一位90岁男性的病例。他患有II型糖尿病二十多年。一天,他注意到双侧上肢无力。第二天早上,症状蔓延至双侧下肢。因此,他被收治到岛根大学医院。磁共振成像(MRI)显示颈椎脊髓有轻度受压,但这并不能解释他的神经症状。由于他的四肢瘫痪病情进展,我们对脑脊液进行了蛋白细胞分离检查。神经传导研究显示为轴索性神经病模式。我们诊断为吉兰 - 巴雷综合征,并在入院后第五天开始静脉注射免疫球蛋白(IVIg)治疗,剂量为5毫克/千克。治疗期间所有深腱反射均消失。一周后他能够起床,两周后能够自行行走。吉兰 - 巴雷综合征是一种可治疗的疾病,即使是老年人出现四肢瘫痪,也应考虑到这种疾病。