急性泛自主神经病病例分析(附4例报告)

Acute panautonomic neuropathy: a report of 4 cases

目的研究急性泛自主神经病(APN)的临床特点,以探讨其诊断要点、治疗和预后。方法回顾性分析4例APN患者的病例资料,对其病史、临床表现、电生理学、脑脊液改变及治疗进行总结。结果4例APN患者均急性起病,有明显的自主神经受累表现:瞳孔异常、腹胀、腹泻、无汗等。肌电图提示轻度神经传导减慢。早期给予激素及静脉注射大剂量免疫球蛋白可能改善其预后。结论APN是一种罕见疾病,了解其临床特点有助于对患者早期诊断和积极治疗。

Objective To explore the clinical manifestations,diagnosis,treatment and prognosis of acute panautonomic neuropathy （APN）.Methods We reviewed the history,clinical findings,electrophysiological characteristics,laboratory features of CSF and treatment of 4 patients with APN.Results All these patients showed acute onset with apparent involvement of the autonomic nervous system.The clinical features of autonomic involvement included fixed dilated pupils,abdominal pain,diarrhea,and anhidrosis.Electromyography showed evidence of peripheral neuropathy.Early treatment with corticosteroid and intravenous immunoglobulins resulted in improved prognosis of the patients.Conclusion APN is a rare autonomic nervous system disorder,and understanding of the clinical features may help in early diagnosis and treatment of the patients.