题名

Pandysautonomia as Initial Presentation of Guillian Barré Syndrome-A Case Report

并列篇名

以泛自主神經失調為初期表現的Guillian Barré症候群：一病例報告

DOI

10.7023/TJFM.200812.0248

作者

黃尹岑(Yin-Tsen Huang)；黃天佑(Tien-Yu Huang)；周兆亮(Chao-Liang Chou)；吳卓鍇(Cho-Kai Wu)；黃麗卿(Lee-Ching Hwang)

关键词

pandysautonomia ； Guillian Barré syndrome ； intravenous immunoglobulins

期刊名称

台灣家庭醫學雜誌

卷期/出版年月

18卷4期（2008 / 12 / 01）

页次

248 - 257

内容语文

英文
中文摘要

自主神經功能障礙的患者在家庭醫學科的門診常見，但是急性的泛自主神經失調：包括嚴重的姿勢性低血壓、腸胃功能障礙、膀胱收縮不良，則可能是Guillian Barré症候群變異型的表現。 病例報告描述一位49歲的男性，罹患急性的泛自主神經失調，經過神經生理學、腦脊髓液等檢查後，診斷爲Guillian Barré症候群的變異型。本案例經施打免疫球蛋白後，病人症狀徵候得到立即緩解。這些發現佐證了本疾病的病因極可能和免疫功能障礙有關，同時也提醒家庭醫學科的醫師注意病患一些初期臨床上非特異性的主訴，本例同時提出診斷與處理的流程以供參考。
英文摘要

Dysfunction of the autonomic nervous system is often encountered in the out-patient clinics of Family Medicine Departments. However, acute pandysautonomia including severe orthostatic hypotension, impaired gastrointestinal and bladder motility could be an uncommon variant of Guillian-Barré syndrome. A 49-year-old male with acute onset of pandysautonomia is reported. Neurophysiological testing and cerebral spinal fluid examination were performed and the GBS variant form was diagnosed. The patient's symptoms were relieved after the administration of intravenous immunoglobulins (IVIGs). These findings are consistent with a dysimmune pathogenesis for the syndrome and suggest a possible treatment and diagnosis process for future cases.
主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Asbury AK,Arnason BG,Adams RD(1969).The inflammatory lesion in idiopathic polyneuritis. Its role in pathogenesis.Medicine,48,173-215.
  2. Dalakas MC(2004).Intravenous immuno-globulin in autoimmune neuromuscular diseases.JAMA,291,2367-2375.
  3. Freeman, R(2005).Autonomic peipheral neuropathy.Lancet,365,1259-1270.
  4. Govoni V,Granieri E,Tola MR(1999).The frequency of clinical variants of Guillain-Barré syndrome in Ferrara.Italy. J Neurol,246,1010-1014.
  5. Heafield MT,Gammage MD,Nightingale S(1996).Idiopathic dysautonomia treated with intravenous gammaglobulin.Lancet,347,28-29.
  6. Ho TW,Mishu B,Li CY,Gao CY(1995).Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies.Brain,118,597-605.
  7. Hughes RA,Cornblath DR(2005).Guillain-Barré syndrome.Lancet,366,1653-1666.
  8. Hughes RA,Raphaël JC,Swan AV(2006).Intravenous immunoglobulin for Guillain-Barré syndrome.Cochrane Database Syst Rev.,25
  9. Hughes RA,Rees JH(1997).Clinical and epidemiologic features of Guillain-Barré syndrome.J Infect Dis,176,92-98.
  10. Hughes RA,Wijdicks EF,Barohn R(2003).Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology.Neurology,61,736-740.
  11. Meilof JF,Kwa VI,Vermeulen M(1998).Isolated ataxia and autonomic dysfunction: a new variant of Guillain-Barré syndrome?.J Neurol Neurosurg Psychiatry,64,689.
  12. Mericle RA,Triggs WJ(1997).Treatment of acute pandysautonomia with intravenous immunoglobul in.J Neurol Neurosurg Psychiatry,62,529-531.
  13. Meythaler JM(1997).Rehabilitation of Guillain-Barré syndrome.Arch Phys Med Rehabil,78,872-879.
  14. Pascuzzi RM,Fleck JD(1997).Acute peripheral neuropathy in adults. Guillain-Barré syndrome and related disorders.Neurol Clin,15,529-547.
  15. Pritchard J,Hughes RA(2004).Guillain-Barré syndrome.Lancet,363,2186-2188.
  16. Suarez GA,Fealey RD,Camilleri M(1994).Idiopathic autonomic neuropathy: clinical, neurophysiologic, and follow-up studies on 27 patients.Neurology,44,1675-1682.
  17. Venkataraman S,Alexander M,Gnanamuthu C(1998).Postinfectious pandysautonomia with complete recovery after intravenous immunoglobulin therapy.Neurology,51,1764-1765.
  18. Young RR,Asbury AK,Adams RD(1969).Pure pan-dysautonomia with recovery.Trans Am Neurol Assoc,94,355-357.
print cancel