神经内科学-格林巴利综合征 PPT课件.ppt

急性感染性多发性神经炎 acute infectious polyneuritis
AIDP:Acute inflammatory demyelinating polynerropathies
GBSGuillain-barre syndrome
它是多发性神经病中的一种特殊类型,除广泛侵犯的神经干及末稍外,还累及神经根,颅神经。
病因
病因未明
疑为与病毒感染有关
自身免疫性疾病
临床表现:运动障碍
A 肢体瘫痪:四肢对称性下运动神经元性瘫痪
B 躯干肌瘫痪:颈肌,肋间肌,膈肌也可出现瘫痪
C 颅神经麻痹:舌咽,迷走和面神经周围性瘫痪多见,其次为动眼,滑车,外展神经。
临床表现:
感觉障碍:以主观感觉障碍为主,肌肉可有明显压痛,仅部分病人可有手套、袜套式感觉障碍。
植物神经功能障碍:多汗,汗臭,初期可有短期尿储留,大便常秘结。
Diagnostic criteria for G-B syndrome
Required for diagnosis
(1) Progressive weakness of more than one limb
(2) Loss of the deep tendon reflexes (areflexes) or hyporeflexes
Supportive of diagnosis --- I
(1) Progression for up to 2-4 weeks
(2) Relatively symmetric deficits
(3) Mild sensory involvement
(4) Cranial nerve (especially VII) involvement
(5) Recovery beginning within 4 weeks after progression stops
Supportive of diagnosis --- II
(6) Autonomic dyfunction cadic,tachycardia
(7) No fever at onset
(8) Increased CSF protein after 1 week
(9) CSF white blood cell count less than 10/mm2
(10) Nerve conduction slowing or block by several weeks