- 期刊
畢氏腦幹腦炎合併Guillain-Barré症候群：病例報告
Bickerstaff's Brainstem Encephalitis Combined with Guillain-Barré Syndrome: A Case Report
摘要
畢氏腦幹腦炎乃是一種感染後的局部腦幹發炎，它的致病因子至今仍然未明，其主要症狀為急性發作之眼外肌麻痺合併複視、運動失調、意識不清及足底伸肌反射增強。本文報告一位33歲的女性於剖腹生產後25天發生畢氏腦幹腦炎且合併發生Guillain-Barré症候群。經過5次血漿置換術及5天的免疫球蛋白治療，病患肌力恢復到MRC (Medical Research Council) scale 4/5分，眼外肌運動正常，雙側足底伸肌反射消失。因仍存有講話不清、運動失調、姿態不穩及複視等症狀，因而轉至復健科病房。復健治療包括了肌力及耐力訓練、動作協調訓練、姿態平衡訓練及步態訓練。病患在接受積極治療及復健之後，有相當良好的神經學及功能上的恢復。
並列摘要
Bickerstaff's brainstem encephalitis is a post-infectious brainstem inflammatory disorder of unknown etiology. The characteristic symptoms include: acute ophthalmoplegia with diplopia, ataxia, disturbed consciousness, and extensor plantar response. In this report we describe a 33-year-old woman with Bickerstaff's brainstem encephalitis combined with Guillain-Barré syndrome that presented 25 days after a Cesarean section. After five treatments with plasmapheresis and intravenous immunoglobin for 5 days, the patient's muscle strength recovered to MRC 4/5. The ophthalmoplegia and bilateral extensor plantar responses also disappeared. The patient then was transferred to the PM&R department for persistent slurred speech, ataxia, and diplopia. The rehabilitation program included training to improve muscle strength and endurance, motor control, balance, and gait training. After intensive treatment and rehabilitation, the patient experienced a successful recovery in neurological and functional status.