Semproni Milena, Gibson Gillian, Kuyper Laura, Tam Penny
Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Department of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
BMJ Case Rep. 2017 Jul 14;2017:bcr-2016-218935. doi: 10.1136/bcr-2016-218935.
We describe a 52-year-old woman presenting with acute onset of severe burning paraesthesia in the hands and feet associated with allodynia and antalgic gait. At the time of admission to hospital no motor weakness was present. A diagnosis of Guillain-Barré syndrome (GBS) was considered when neurophysiological studies were completed showing convincing evidence of demyelination on motor conduction studies and sural sparing on sensory nerve studies. We describe this case as a sensory variant of GBS. Clinical improvement followed treatment with a single course of intravenous immunoglobulin (IVIG). The patient made a complete clinical recovery within 6 months of onset and repeat neurophysiological studies showed marked improvement. We encourage clinicians to consider an atypical variant of GBS in patients presenting with acute sensory complaints.
我们描述了一位52岁女性，其手部和足部突然出现严重的烧灼样感觉异常，并伴有痛觉过敏和避痛性步态。入院时无运动无力症状。神经生理学研究完成后，考虑诊断为吉兰-巴雷综合征（GBS），运动传导研究显示有令人信服的脱髓鞘证据，感觉神经研究显示腓肠神经未受累。我们将此病例描述为GBS的感觉变异型。经单疗程静脉注射免疫球蛋白（IVIG）治疗后临床症状改善。患者在发病后6个月内临床完全康复，重复神经生理学研究显示有显著改善。我们鼓励临床医生在出现急性感觉症状的患者中考虑GBS的非典型变异型。
