急性热病性多神经炎神经病学双语课件.ppt

case Male,35years old,complained of weakness of four limbs for 1 day on admission.He had a cold 2 weeks before admission.the weakness became severe and lead to tetraplegia on the 3 day.Aphagia appeared almost the same time.Numbness of fingers and toes was mentioned.He had no difficulties on micturation. exam Cranial nerves:diminished elevation of palatal,gag reflex disappear Motor system:muscle tension decreased; muscle force: 0 grade of all four limbs. Sensory system:slightly stocking-glove type pain decreased. Reflex:areflexia.Babinski’s sign:(-). Others:normal. Acute Inflammatory Demyelinating Polyneuropathy Guillain-Barre Syndrome zhao dongxue Etiology and Pathology Etiology: unknown. cell-mediated immunologic reaction Pathology: Perivascular lymphocytic infiltrates Perivenous segmental demyelinating Clinical Features(I) Preceding infection: Motor system:weakness of limbs symmetic and flaccid respiratory failure Clinical Features(II) Sensory system: stocking-glove type Clinical Features(III) Cranial nerves:facial diplegia. bulbar palsy others. Autonomic dysfunction:tachycardia labile blood pressure disturbed sweating Sphincter function:not involved usually Laboratory Findings CSF:protein-cell dissociation on the third week Electrophysiology:MCV and SCV slowed Diagnosis Preceding Infection Clinical Features Laboratory Findings Differential Diagnosis Periodic paralysis Poliomyelitis Myasthenia Gravis Treatment Symptomatic Treatmeat: Etiologic Treatment: plasmaexchange intr