Morrissey Hannah, Ali Farman, John Collin, Pawar Gauri, McQuade Elizabeth A
General Pediatrics, West Virginia University Medicine, Morgantown, USA.
Adult Neurology, West Virginia University Medicine, Morgantown, USA.
Cureus. 2022 Jan 19;14(1):e21417. doi: 10.7759/cureus.21417. eCollection 2022 Jan.
Beriberi neuropathy (thiamine deficiency) and Guillian-Barre Syndrome (GBS) both can present with areflexia and progressive ascending weakness. A physical examination can be equivocal between the two. In cases where GBS is suspected clinically but initial work-up with cerebral spinal fluid (CSF) studies and magnetic resonance imaging (MRI) of the spine are not diagnostic, nerve conduction study/electromyography (NCS/EMG) should be done to evaluate beriberi neuropathy. Presumptive treatment should be started while awaiting confirmation from nutritional laboratory investigations. Here we present a rare case of a GBS mimic involving a 17-year-old patient with food restriction that led to thiamine deficiency causing beriberi neuropathy and Wernicke encephalopathy.
脚气病性神经病(硫胺素缺乏)和吉兰 - 巴雷综合征(GBS)都可能表现为腱反射消失和进行性上行性肌无力。两者的体格检查结果可能难以区分。临床上怀疑GBS但最初的脑脊液(CSF)检查和脊柱磁共振成像(MRI)无诊断价值时,应进行神经传导研究/肌电图(NCS/EMG)以评估脚气病性神经病。在等待营养实验室检查确认期间应开始经验性治疗。在此,我们报告一例罕见的GBS疑似病例,该病例为一名17岁患者,因食物限制导致硫胺素缺乏,进而引发脚气病性神经病和韦尼克脑病。