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作者报告3例格林—巴利综合征(GBS)患者马尾和腰神经根的增强MRI特点。例1,男,56岁,因腰背痛,进行性四肢无力5天入院,并有尿潴留。查体:轻度构音障碍,四肢对称性肌力减退,近端重于远端,双膝部本体感觉减退,腱反射消失,病理反射(一)。CBC计数、电解质、ESR、CK、肝功能正常,血清学检查包括梅毒、莱姆病、HIV呈阴性。CSF:蛋白2.178/L、WBC15×10~9/L、糖3.89mmol/L,VDRL、隐球菌抗原,弓形体效价,结核菌培养均呈阴性。病后15天行腰髓增强MRI显示。马尾和腰骶神经根(L3—S1)异常强化,无压迫性病变。神经传导研究显示脱髓鞘性感觉运动多神经病,采用血浆析出法治疗,2周后肌力改善。例2,男,3岁,因病毒感染双下肢疼痛、无力1周入院,并有小便淋漓和失禁。查体:双下肢肌无力,Gower’s征阳性,共济失调步态,跟腱反射消失,病理反射(一)。电解质、CBC计数、CK、肝功能正常,蛋白电泳、莱姆效价及HIV阴性,ESR62mm/h。CSF:WBC5×10~9/
The authors report the enhanced MRI features of the cauda equina and lumbar nerve roots in 3 patients with Guillain-Barre syndrome (GBS). Example 1, male, 56 years old, due to low back pain, progressive limb weakness 5 days admission, and urinary retention. Physical examination: mild dysarthria, symmetry of the limbs weakness, proximal heavier distal, knee weakening of the body, tendon reflex, pathological reflexes (A). CBC count, electrolytes, ESR, CK, normal liver function, serological tests including syphilis, Lyme disease, HIV negative. CSF: protein 2.178 / L, WBC15 × 10 ~ 9 / L, sugar 3.89mmol / L, VDRL, cryptococcal antigen, toxoplasma titers, mycobacterium tuberculosis were negative. 15 days after the disease line lumbar enhanced MRI showed. Horsetail and lumbosacral nerve root (L3-S1) abnormal enhancement, no pressure lesions. Nerve conduction studies have shown demyelinating sensory and motor polyneuropathy, treated with plasmapheresis, and improved muscle strength after 2 weeks. Example 2, male, 3 years old, due to viral infection of lower extremity pain, weakness 1 week hospitalization, and urine dripping and incontinence. Physical examination: weakness of both lower extremities, Gower’s sign positive, ataxia gait, disappearance of Achilles tendon reflex, pathological reflexes (A). Electrolytes, CBC count, CK, normal liver function, protein electrophoresis, Lyme potency and HIV negative, ESR62mm / h. CSF: WBC5 × 10 ~ 9 /