周圍神經(jīng)病-中國(guó)協(xié)和醫(yī)科大學(xué)(編輯修改稿)
2025-02-02 00:34 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 瘤浸潤(rùn)，結(jié)締組織病，甲低，等 吉蘭 —巴雷綜合征 GuillainBarre syndrome GuillainBarre syndrome ? 1859年 Landry’s Acending paralysis ? 1892年 acute febrile polyneuroritis ? 1918年 acute infective polineuritis ? 1916年 Guillain BarreStrohl syndrome Pathologic changes of AIDP Mechanism——Antecedent events for GBS ? Infections viruses EB virus Cytomegalovirus HIV Infuenza virus Coxsackie viruses Herpes simplex Hepatitis A and C viruses Others Bacterial infection Campylobacter jejuni Mycoplasma pneumoniac Escherichia coli Others Parastic Mararia Toxoplasmosis Antecedent events for GBS ? Systemic illnesses Hodgkin’s disease lymphocytic leukemia Hyperthoidism Collagen vascular diseases Sarcoidosis Renal disease ? Other medical condition Pregnancy Surgical procedures Bone marrow transplantation Immunizations Envenomization Drug ingestion Immunopathology Mechanism molecular mimicry Classification of GBS ? AIDP Acute Inflammatory Demyelinating Polyneuropathy ? Miller Fisher syndrome ? Acute panautonomic neuropathy(APN) ? acute sensory neuropathy, ASN ? AMAN/AMSAN Acute Motor / Sensory Axonal Neuropathy Concept of GBS ? Acute or subacute onset ? Peripheral neuropathy ? albuminocytologic dissociation in CSF ? Immunemediated neuropathy ? spontaneous recovery in most cases ? Monophasic course Epidemiology ? Incidence 12 cases per 100,000 general population ? All ages, mean age is 40y ? All races and nationalities ? A slight male predominance Clinical features of AIDP(1) ? 50% have paresthesias and pain at beginning ? followed by weakness most begin in the legs
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