Nishida Katsuya, Sakashita Kento, Uchibori Ayumi, Chiba Atsuro, Futamura Naonobu
Division of Neurology, National Hospital Organization Hyogo-Chuo National Hospital.
Department of Neurology, Faculty of Medicine, Kyorin University.
Rinsho Shinkeigaku. 2022 Apr 27;62(4):293-297. doi: 10.5692/clinicalneurol.cn-001710. Epub 2022 Mar 29.
A 75-year-old man with a history of hypertension developed weakness and sensory disturbance in the extremities 1 week after upper respiratory tract infection and faced difficulty walking. Screening at the time of hospital admission revealed an incidental positive SARS-CoV-2 PCR test, and COVID-19 was diagnosed. Neurological findings showed dysarthria, dysphagia, absence of deep tendon reflexes in the extremities, distal-dominant muscle weakness, sensory disturbance, urinary retention and constipation. Nerve conduction studies showed prolonged distal latency, decreased conduction velocity, and poor F-wave response, leading to a diagnosis of COVID-19-associated Guillain-Barré syndrome (GBS). The patient was treated with intravenous immunoglobulin, and his neurological symptoms improved without the need of a ventilator. Anti-ganglioside autoantibodies were negative. The patient developed GBS during the infectious period of SARS-CoV-2 and was treated in the isolation ward by clinical staff with personal protective equipment. Because COVID-19-associated GBS can develop during the infectious period of SARS-CoV-2, it is important for neurologists to consider GBS and other neurological disorders as being potentially COVID-19-related, and to treat patients with COVID-19 accordingly.
一名75岁男性，有高血压病史，在上呼吸道感染1周后出现四肢无力和感觉障碍，行走困难。入院筛查时发现SARS-CoV-2 PCR检测偶然呈阳性，确诊为COVID-19。神经系统检查发现构音障碍、吞咽困难、四肢腱反射消失、以远端为主的肌肉无力、感觉障碍、尿潴留和便秘。神经传导研究显示远端潜伏期延长、传导速度减慢和F波反应不佳，诊断为COVID-19相关吉兰-巴雷综合征（GBS）。患者接受了静脉注射免疫球蛋白治疗，其神经症状改善，无需使用呼吸机。抗神经节苷脂自身抗体为阴性。该患者在SARS-CoV-2感染期发生GBS，由配备个人防护装备的临床工作人员在隔离病房进行治疗。由于COVID-19相关GBS可在SARS-CoV-2感染期发生，神经科医生将GBS和其他神经系统疾病视为可能与COVID-19相关并相应治疗患者很重要。
