増大特集 神経疾患の診断における落とし穴-誤診を避けるために 末梢神経疾患
増大特集 神経疾患の診断における落とし穴-誤診を避けるために 末梢神経疾患
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延伸专题：诊断神经系统疾病的陷阱 - 如何避免误诊周围神经疾病
DOI：
10.11477/mf.1416201536
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
神田 隆
中科院分区：
文献类型：
--
作者：
松尾 欣哉;古賀 道明;神田 隆
神经系统疾病的诊断过程包括解剖学和病因学诊断，神经病的诊断过程通常始于基于神经学发现的周围神经障碍的怀疑，随后通过电生理学证实。然而，在解剖诊断过程中，在解释神经学特征和电生理数据方面存在许多陷阱，可能导致对脊髓病、肌病、神经肌肉接头疾病或运动神经元疾病患者的”神经病”的误诊。我们报告一个7岁女孩的病例，她在神经传导检查中表现为急性弛缓性四肢瘫痪，并有明显的异常，最初被误诊为格林-巴利综合征。回顾过去，我们认识到除了神经病以外的其他疾病的几点暗示。
The Diagnostic process of neurological disorders consists of anatomical and etiological diagnoses, and that of neuropathies usually starts with a suspicion of peripheral nerve disturbance based on neurological findings, which is subsequently confirmed by electrophysiology. However, there are numerous pitfalls in interpreting neurological features and electrophysiological data in the anatomical diagnosis process, possibly leading to misdiagnoses of" neuropathy" in patients with myelopathies, myopathies, neuromuscular junction diseases, or motor neuron diseases. We present the case of a 7-year-old girl showing acute flaccid quadriplegia with overt abnormalities in a nerve conduction study who was initially misdiagnosed with Guillain-Barré syndrome. In retrospect, we recognize several points suggestive of disorders other than neuropathy.