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物质使用后双侧全神经丛病变:一例报告。

Bilateral pan-plexus lesion after substance use: A case report.

作者信息

Eker Büyükşireci Dilek, Polat Musa, Zinnuroğlu Murat, Cengiz Bülent, Kaymak Karataş Gülçin Kaymak

机构信息

Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey.

Department of Neurology, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

Turk J Phys Med Rehabil. 2019 Nov 22;65(4):411-414. doi: 10.5606/tftrd.2019.3157. eCollection 2019 Jun.

Abstract

Peripheral nervous system complications such as acute demyelinating polyradiculopathy and mononeuropathy may rarely develop after substance use. A 27-year-old man used illegal drugs the day before his admission to the emergency service. Initially, he was suspected for rhabdomyolysis, due to elevated blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, myoglobin, and creatine kinase levels. On Day 4, generalized edema and flask paralysis were noted in both upper limbs. The patient was diagnosed with bilateral brachial pan-plexopathy based on electrophysiological study results. He underwent a rehabilitation program. After eight months, repeated electrophysiological study revealed a significant improvement in all bilateral upper limb muscles, except for the right abductor pollicis brevis and abductor digiti minimi muscles. The underlying cause of bilateral brachial pan-plexopathy was rhabdomyolysis secondary to substance use. In conclusion, substance use in patients with non-traumatic plexopathy should always be questioned.

摘要

周围神经系统并发症,如急性脱髓鞘性多发性神经根病和单神经病,在使用药物后可能很少发生。一名27岁男子在入住急诊服务的前一天使用了非法药物。最初,由于血尿素氮、肌酐、天冬氨酸转氨酶、丙氨酸转氨酶、肌红蛋白和肌酸激酶水平升高,他被怀疑患有横纹肌溶解症。在第4天,双上肢出现全身性水肿和烧瓶样麻痹。根据电生理研究结果,该患者被诊断为双侧臂丛神经全瘫。他接受了康复治疗。八个月后,重复电生理研究显示,除右侧拇短展肌和小指展肌外,所有双侧上肢肌肉均有显著改善。双侧臂丛神经全瘫的根本原因是药物使用继发的横纹肌溶解症。总之,对于非创伤性神经丛病患者,应始终询问其是否使用过药物。

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