Guillain-Barré Syndrome引發雙側顏面癱瘓--個案報告及文獻回顧

Guillain-Barré Syndrome Presenting with Facial Diplegia: A Case Report and Literature Review

急性單側顏面神經麻痺為常見的特發性良性疾病，雙側顏面神經麻痺則很罕見，多潛藏系統性病因而需進一步診察。本個案於急性上呼吸道感染後，出現雙足雙手麻木，因劇烈頭頸部疼痛至急診，隨後有四肢肌無力及深部肌腱反射消失、自主神經功能異常、延髓及雙側顏面神經麻痺，經腦脊髓液及神經電生理檢查診斷為急性發炎性脫髓鞘多發神經根神經病變(acute inflammatory demyelinating polyradiculoneuropathy, AIDP)。本文針對Guillain-Barré症候群進行文獻回顧，協助臨床醫師能即時辨識並轉診。

 

Unilateral peripheral facial nerve palsy is a common, relatively benign, and usually idiopathic condition. Unlike the unilateral form, simultaneous bilateral facial paralysis is a rare clinical entity that often indicates a serious underlying systemic disease that warrants urgent investigation and treatment. We reported a case of a 34-year-old healthy man developing paresthesia in both feet and hands after acute upper respiratory tract infection. Afterwards, he went to an emergency department for severe headache and neck pain, followed by quadriparesis, areflexia, autonomic dysfunction, bulbar weakness, and bilateral facial paralysis. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was later diagnosed by cerebrospinal fluid analysis and electrophysiological examination. The literature on Guillain-Barré syndrome was reviewed herein to facilitate prompt recognition and timely referral of this potentially life-threatening disease.