Anımsatma: Guillain-Barré Sendromunda Kuvvet Kaybı Asimetrik Olabilir

Year 2014, , 28 - 31, 01.01.2014

Turgay Çokyaman Emine Tekin Ömer Faruk Aydın Haydar Ali Taşdemir Hamit Özyürek

https://doi.org/10.5222/j.child.2014.028

Abstract

Guillain-Barré sendromu GBS hızlı progresyon gösteren, simetrik ve aşağıdan yukarı doğru ilerleyen güçsüzlük ve arefleksi ile karakterize olan akut, demiyelinizan, inflama- tuvar bir polinöropatidir 1 . Kraniyal nöropati ve otonomik semptomlar bu tabloya eşlik edebilir 2 . Bu makalede, bila- teral alt ekstremitelerde şiddetli ağrıları ve sol alt ekstremi- te proksimalinde kuvvet kaybı sağa göre daha belirgin olan ve idrar inkontinansı gelişen bir vaka sunulmuştur. Elektromiyografi bulguları akut motor duysal aksonal nöropati AMSAN lehine değerlendirilmiş ve beyin-omirlik sıvısı analizi ve spinal manyetik rezonans görüntüleme ile de tanı desteklenmiştir. İntravenöz immunglobulin IVIG tedavisinden iki hafta sonra klinik düzelme görülmüş ve fizik tedavi ve rehabilitasyon programına alınmıştır. Asimetrik kuvvet kaybı ile presente olan GBS vakaları lite- ratürde ender olarak bildirilmektedir

Keywords

Guillain-Barré sendromu, güçsüzlük, arefleksi

Reminder: Loss of Strength in Guillain-Barré Syndrome May Be Asymmetric

Abstract

Guillain-Barré syndrome GBS is a rapidly progressive, symmetrical and ascending acute demyelinating inflamma- tory polyneuropathy which is characterized by progressive weakness and areflexia. Cranial neuropathy and autonomic symptoms may accompany the clinical picture. In this paper, a case with severe pain in the bilateral lower extremities and left lower limb proximal muscle weakness which is signifi- cantly more marked than the right side and urinary inconti- nence was presented. Electromyography EMG findings were evaluated in favour of acute motor sensory axonal neuropathy AMSAN and the diagnosis was supported by cerebrospinal fluid analysis and magnetic resonance ima- ging. Two weeks after the intravenous immunoglobulin IVIG treatment clinical improvement was observed and the patient was included in physical therapy and rehabilitation program. GBS cases who present with asymmetric weakness have been rarely reported in the literature

Keywords

Guillain-Barré syndrome, weakness, areflexia

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