Treatment of Dysphagia with Pyridostigmine Bromide in a Patient with the Pharyngeal- Cervical-Brachial Variant of Guillain-Barré Syndrome
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A 24-year-old male developed bulbar palsy, ophthalmoplegia, ptosis, and shoulder weakness bilaterally 2 weeks after he had experienced an upper respiratory infection. The electrodiagnostic study demonstrated axonal polyradiculoneuropathy. The repetitive nerve stimulation study (RNS) showed no significant decrement of the compound muscle action potentials (CMAPs). The videofluoroscopic swallowing study (VFSS) showed severe impairment of the pharyngeal phase of swallowing. He was diagnosed as having the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. The patient’s dysphagia was not improved for 3 months. A follow up RNS showed a signifi cant decrement of the CMAPs. Pyridostigmine bromide was tried to improve the dysphagia. Th e patient showed immediate improvement of his dysphagia on the VFSS after the trial with pyridostigmine bromide. Pyridostigmine bromide was given before each meal for 8 days and he showed continuous improvement of his dysphagia. Th e follow up VFSS after 3 months showed complete recovery of dysphagia.
Abstract
A 24-year-old male developed bulbar palsy, ophthalmoplegia, ptosis, and shoulder weakness bilaterally 2 weeks after he had experienced an upper respiratory infection. The electrodiagnostic study demonstrated axonal polyradiculoneuropathy. The repetitive nerve stimulation study (RNS) showed no significant decrement of the compound muscle action potentials (CMAPs). The videofluoroscopic swallowing study (VFSS) showed severe impairment of the pharyngeal phase of swallowing. He was diagnosed as having the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. The patient’s dysphagia was not improved for 3 months. A follow up RNS showed a signifi cant decrement of the CMAPs. Pyridostigmine bromide was tried to improve the dysphagia. Th e patient showed immediate improvement of his dysphagia on the VFSS after the trial with pyridostigmine bromide. Pyridostigmine bromide was given before each meal for 8 days and he showed continuous improvement of his dysphagia. Th e follow up VFSS after 3 months showed complete recovery of dysphagia.
참고문헌 (10)
- Ropper AH, "Unusual clinical variants and signs in Guillain-Barre syndrome", Arch Neurol, 43, pp.1150~1152 (1986)
- Arai M, "Axonal pharyngeal-cervical- brachial variant of Guillain-Barre syndrome without Anti-GT1a IgG antibody", Muscle Nerve, 28, pp.246~250 (2003)
- Kim SY, "Pharyngeal- cervical-brachial variants of Guillain-Barre syndrome", J Korean Neurol Assoc, 12, pp.164~169 (1994)
- Asbury AK, "Assessment of current diagnostic criteria for Guillain-Barre syndrome", Ann Neurol, 27, pp.21~24 (1990)
- Thomann KH, "Myasthenia gravis: pathophysiology, diagnosis, diff erential diagnosis and management", Clinical Eye and Vision Care, 7, pp.3~13 (1995)
- Miglietta OE, "Myasthenic-like response in patients with neuropathy", Am J Phys Med, 50, pp.1~16 (1971)
- Hughes RA, "Pathogenesis of Guillain-Barre syndrome", J Neuroimmunol, 100, pp.74~97 (1999)
- Mogale KD, "The pharyngealcervical- brachial form of Guillain-Barre syndrome in childhood", Pediatr Neurol, 33, pp.285~288 (2005)
- Murakami N, "An adolescent with pharyngealcervical- brachial variant of Guillain-Barre syndrome after cytomegalovirus infection", Brain Dev, 28, pp.269~271 (2006)
- Palmer JB, "Evaluation and treatment of swallowing impairments", Am Fam Physician, 61, pp.2453~2462 (2000)