Internal Medicine, University of Pittsburgh Medical Center Health System, McKeesport, Pennsylvania, USA.
Internal Medicine, University of Pittsburgh Medical Center Health System, McKeesport, Pennsylvania, USA
BMJ Case Rep. 2022 May 9;15(5):e249749. doi: 10.1136/bcr-2022-249749.
A Caucasian man in his 60s with a medical history significant for ruptured left middle cerebral artery aneurysm status post clipping 2005 with residual right eye blindness and right leg weakness with gait instability presented with loss of balance, weakness of his legs and fatigue for 3 days. No other antecedent event was identified other than receiving Moderna COVID-19 vaccine 4 weeks before the presentation and 3 days before symptom onset. CT head and CT angiogram of the head and neck were performed and demonstrated no acute intracranial bleeding and no vascular abnormalities. With the findings of diffuse hyporeflexia and cerebrospinal fluid showing albumino-cytological dissociation, Guillain-Barré syndrome was high on the differentials. Electromyogram showed evidence of demyelination. He was treated with intravenous immune globulin (IVIG) and was discharged to rehab with complete symptom resolution.
一位 60 多岁的高加索男性,既往病史为左侧大脑中动脉破裂动脉瘤,2005 年夹闭术后遗留右眼失明和右腿无力伴步态不稳,此次以 3 天的平衡障碍、腿部无力和疲劳为主要表现。除了在就诊前 4 周和症状出现前 3 天接种 Moderna COVID-19 疫苗外,无其他前驱事件。行头颅 CT 和头颈部 CT 血管造影检查,未见急性颅内出血和血管异常。根据广泛的反射减弱和脑脊液蛋白细胞分离的发现,格林-巴利综合征的鉴别诊断较高。肌电图显示脱髓鞘的证据。他接受了静脉注射免疫球蛋白(IVIG)治疗,症状完全缓解后出院至康复科。