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Acute Inflammatory Demyelinating Polyneuropathy and a Unilateral Babinski/Plantar Reflex

机译:急性炎症性脱髓鞘性多发性神经病和单侧Babinski / Plantar Reflex

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摘要

Acquired acute demyelinating peripheral polyneuropathy (AADP) is a general classification of pathologies that could affect secondary the peripheral nervous system. They are characterized by an autoimmune process directed towards myelin. Clinically they are characterized by progressive weakness and mild sensory changes. Acute inflammatory demyelinating polyneuropathy often is referred to as Guillain-Barré syndrome (GBS). GBS is the major cause of acute nontraumatic paralysis in healthy people and it is caused by autoimmune response to viral agents (influenza, coxsackie, Epstein-Barr virus, or cytomegalovirus) or bacterial infective organisms (Campylobacter jejuni, Mycoplasma pneumoniae). A detailed history, with symptoms of progressive usually bilateral weakness, hyporeflexia, with a typical demyelinating EMG pattern supports the diagnosis. Progressive affection of respiratory muscles and autonomic instability coupled with a protracted and unpredictable recovery normally results in the need for ICU management. We present a case report of a patient with a typical GBS presentation but with a unilateral upgoing plantar reflex (Babinski sign). A unifying diagnosis was made and based on a literature search in Pubmed appears to be the first described case of its kind.
机译:获得性急性脱髓鞘性周围神经炎(AADP)是可能影响继发性周围神经系统的病理的一般分类。它们的特征在于针对髓磷脂的自身免疫过程。临床上,它们的特征是进行性无力和轻度的感觉改变。急性炎症性脱髓鞘性多发性神经病通常被称为格林-巴利综合征(GBS)。 GBS是健康人急性非创伤性麻痹的主要原因,它是由对病毒制剂(流感,柯萨奇,爱泼斯坦-巴尔病毒或巨细胞病毒)或细菌感染性生物(空肠弯曲杆菌,肺炎支原体)的自身免疫反应引起的。详细的病史(通常伴有进行性双侧无力,反射不足和典型的脱髓鞘肌电图模式)有助于诊断。呼吸肌的渐进性感染和自主神经的不稳定性,加上长期的和不可预测的恢复,通常需要ICU管理。我们提出一个案例具有典型GBS表现但有单侧向上plant反射(Babinski征)。统一诊断并基于Pubmed中的文献检索似乎是第一个描述的此类案例。

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