以泛自主神經失調為初期表現的Guillian Barré症候群：一病例報告

Pandysautonomia as Initial Presentation of Guillian Barré Syndrome－－A Case Report

自主神經功能障礙的患者在家庭醫學科的門診常見，但是急性的泛自主神經失調：包括嚴重的姿勢性低血壓、腸胃功能障礙、膀胱收縮不良，則可能是Guillian Barré症候群變異型的表現。病例報告描述一位49歲的男性，罹患急性的泛自主神經失調，經過神經生理學、腦脊髓液等檢查後，診斷為Guillian Barré症候群的變異型。本案例經施打免疫球蛋白後，病人症狀徵候得到立即緩解。這些發現佐證了本疾病的病因極可能和免疫功能障礙有關，同時也提醒家庭醫學科的醫師注意病患一些初期臨床上非特異性的主訴，本例同時提出診斷與處理的流程以供參考。

Dysfunction of the autonomic nervous system is often encountered in the out-patient clinics of Family Medicine Departments. However, acute pandysautonomia including severe orthostatic hypotension, impaired gastrointestinal and bladder motility could be an uncommon variant of Guillian-Barré syndrome. A 49-year-old male with acute onset of pandysautonomia is reported. Neurophysiological testing and cerebral spinal fluid examination were performed and the GBS variant form was diagnosed. The patient's symptoms were relieved after the administration of intravenous immunoglobulins (IVIGs). These findings are consistent with a dysimmune pathogenesis for the syndrome and suggest a possible treatment and diagnosis process for future cases.