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米勒费舍尔综合征和吉兰-巴雷综合征:复杂病例的双重干预康复。

Miller Fisher syndrome and Guillain-Barré syndrome: dual intervention rehabilitation of a complex patient case.

机构信息

Department of Physical Therapy, Ithaca College, Ithaca, NY, USA.

Inpatient Therapy Department, Cayuga Medical Center, Ithaca, NY, USA.

出版信息

Physiother Theory Pract. 2022 Jan;38(1):245-254. doi: 10.1080/09593985.2020.1736221. Epub 2020 Mar 9.

DOI:10.1080/09593985.2020.1736221
PMID:32149554
Abstract

: Guillain-Barré syndrome (GBS) presents with acute peripheral neuropathy leading to ascending motor and sensory deficits. Miller Fisher syndrome (MFS), a GBS variant, is characterized by ophthalmoplegia, ataxia, and areflexia. In unusual cases, MFS and GBS overlap. The purpose of this case report is to illustrate the effects of an aquatic and land-based physiotherapy (PT) intervention on a patient with MFS-GBS.: A 57-year-old male physician was diagnosed with complex regional pain syndrome following a quadriceps muscle tear. Within 1 month, the patient experienced evolving motor, sensory, autonomic, and cranial nerve dysfunction and was diagnosed with MFS-GBS.: Five months post-onset, a 7-week intensive PT program was initiated including aquatic and land-based interventions.: Following completion, functional improvements were demonstrated on the 6 Minute Walk Test, Timed-Up-and-Go, 10 Meter Walk Test and Short Form-36. However, 6 weeks after program completion, the patient had a recurrence.: PT intervention demonstrated improvement in functional outcomes for a patient with a diagnosis of MFS-GBS. Complex patients lacking recovery within 6 months may benefit from continued rehabilitation. Other intervention approaches may need to be considered, including aquatic therapy.

摘要

格林-巴利综合征(GBS)表现为急性周围神经病,导致上行运动和感觉功能障碍。米勒费舍尔综合征(MFS)是 GBS 的一种变体,其特征为眼肌麻痹、共济失调和反射消失。在不常见的情况下,MFS 和 GBS 会重叠。本病例报告的目的是说明水上和陆地物理治疗(PT)干预对 MFS-GBS 患者的影响。

一名 57 岁男性医生在股四头肌撕裂后被诊断为复杂性区域疼痛综合征。在 1 个月内,患者出现进行性运动、感觉、自主和颅神经功能障碍,并被诊断为 MFS-GBS。

发病后 5 个月,开始了为期 7 周的强化 PT 计划,包括水上和陆地干预。

完成后,6 分钟步行测试、计时起立行走测试、10 米步行测试和简明健康状况调查问卷的功能改善。然而,在计划完成后 6 周,患者复发。

PT 干预显示出对 MFS-GBS 诊断患者的功能结局的改善。6 个月内没有恢复的复杂患者可能受益于持续康复。可能需要考虑其他干预方法,包括水上治疗。

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