摘要
目的研究老年Miller-Fisher综合征(MFS)患者的临床和电生理特征,并分析其预后。方法对9例老年MFS患者的临床表现、辅助检查、治疗和预后进行回顾性总结分析。结果本组男女比例4:5,患病年龄(68.3±4.1)岁,病程(19.2±9.9)d,发病主要在春冬季节,有呼吸道感染前驱史者3例,首发症状主要为头晕、头痛、眼睑下垂、复视、行走不稳和肢体麻木无力,起病至达峰平均(2.7±2.8)d;患者均有眼肌麻痹、共济失调和腱反射减弱或消失,眼胀痛5例,眼内肌受累2例,面神经受累4例,舌咽、迷走神经受累3例,四肢肌力减退3例,远端浅感觉减退或消失6例,自主神经受累3例;血清抗GQ1b抗体阳性5例,脑脊液示蛋白细胞分离6例,四肢肌电图异常7例,主要表现为感觉神经传导受累5例;患者应用激素和(或)免疫球蛋白治疗,头痛、眼胀痛、肢体麻木症状最早改善,眼外肌麻痹、共济失调分别在(2.5±1.5)d、(6.3±3.8)d时开始改善,腱反射异常在2~3周出院时无明显恢复;患者住院(15.0±4.6)d,出院时均好转。结论老年MFS临床表现多样,肌电图主要表现为感觉神经传导受累,血清抗GQ1b抗体有助于诊断,激素和(或)免疫球蛋白治疗后好转。
Objective To study the clinical, electrophysiological features and prognosis of the Miller-Fisher Syndrom （MFS）. Method A total of 9 elderly patients with MFS were retrospective observed according to clinical manifestations, auxiliary examination,treatment and prognosis. Result Among this groups,male female ratio was 4：5, the mean age was 68.3 ±4. 1 years, the mean course was 19.2±9.9 days,onset in spring and winter was predominant,3 cases were involved with respiratory tract in- fection;As the initial symptom, there were dizziness, headache, drooping eyelids, diplopia, walking instability and numbness and weakness of limbs,the mean time of onset to peak was 2.7±2.8 days;All the patients was charactered with the ophthalmoplegia, taxia and areflexia,there are five eases with ophthalmalgia, two eases with intraoeular muscles, four cases with facial nerve dam- aged, three eases with glossopharyngeal and vagus nerve damaged, three eases with decreased myodynamia, six eases with superfi- cial loss or disappearance of the distal extremities,three eases with autonomic nerve involvement;Five eases with anti-GQlb anti- body positive, six eases are of obvious albuminocytolgoic dissociation of eerebrospinal fluid, seven eases with damage by the electro- myography,and five eases with sensory nerve conduction involvement; The immunoglobulin and/or methylprednisolone therapy are for all cases, the headache,ophthalmalgia,numbness of the limbs were improved earliest,and ophthalmoplegia, taxia began to im- prove at an average of 2.5 ± 1.5 days. 6.3±3.8 days respectively, the areflexia was no improvement at 2± 3 weeks when dis- charged from hospital. The average time of staying hospital was 15.0± 4.6 days, and they all improved at discharge. Conclusion The clinical manifestations are diverse of the elderly with MFS. It is mainly involved in sensory nerve conduetion of Electromyo- graphy. Serum anti GQlb antibodies are useful for the diagnosis. And it is improved after immunoglobulin and/or methylpred- nisolone treatme
作者
李刚
宋佳
庞咪
马明明
徐长水
张杰文
Li Gang Song Jia Pang Mi Ma Mingming Xu Changshui Zhang Jiewen(Department of Neurology, Henan Provincial People＇s Hospital＆ The People ＇ s Hospital of Zhengzhou University＆ The People ＇ s Hospital of Henan University ,Zhengzhou 450003 ,Chin)
出处
《中国实用神经疾病杂志》
2017年第14期79-81,共3页
Chinese Journal of Practical Nervous Diseases
