RESUMO
A 40-year-old woman consulted our ED for a 7-month history of left dorsal back pain and dyspnea. The pain was initially dull and mechanical. Her general practitioner started nonsteroidal antiinflammatory drugs and physiotherapy, which provided partial relief. One week before consulting, the intensity of the pain increased, and she started to feel shortness of breath when performing her daily activities. She had lost 5 kg during the previous month. The patient was a healthy woman who lived in an urban area of Barcelona, Spain. She did not smoke or take drugs of abuse, and she worked as a butcher. During the initial evaluation, her blood pressure was 131/76 mm Hg, heart rate was 120 beats/min, temperature was 36.2°C, and ambient air pulse oximetry was 98%.
Assuntos
Dor nas Costas/etiologia , Neoplasias de Bainha Neural/diagnóstico , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/cirurgia , Neoplasias Torácicas/diagnóstico , Adulto , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Neoplasias de Bainha Neural/cirurgia , Neoplasias Torácicas/cirurgiaRESUMO
El síndrome de Guillain-Barré es una polineuropatía desmielinizante inflamatoria aguda, existiendo variantes locorregionales poco frecuentes como la faringo-cérvico-braquial. Presentamos el caso de un varón de 63 años de edad que acudió a urgencias por debilidad de extremidades superiores y a nivel cervical, con incapacidad para deglutir y masticar, y una insuficiencia respiratoria aguda rápidamente progresiva por debilidad de músculos respiratorios, todo ello secundario a la variante faringo-cérvico-braquial del síndrome de Guillain-Barré. Esta variante, aunque poco frecuente, presenta un patrón clínico y unos criterios diagnósticos bien definidos, importantes de reconocer para poder así iniciar de forma precoz el tratamiento y mejorar el pronóstico, no siempre favorable, de estos pacientes.
Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Guillain-Barré/diagnóstico , Debilidade Muscular/diagnóstico , Doenças Faríngeas/diagnóstico , Insuficiência Respiratória/diagnóstico , Diagnóstico Diferencial , Extremidades , Síndrome de Guillain-Barré/complicações , Músculo Esquelético , Debilidade Muscular/etiologia , Orofaringe , Doenças Faríngeas/etiologia , Músculos Respiratórios , Insuficiência Respiratória/etiologiaAssuntos
Amnésia Global Transitória/etiologia , Coito , Inibidores da Fosfodiesterase 5/efeitos adversos , Piperazinas/efeitos adversos , Sulfonamidas/efeitos adversos , Vasodilatadores/efeitos adversos , Veias Cerebrais/fisiopatologia , Coito/fisiologia , Hipocampo/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Neuroimagem , Purinas/efeitos adversos , Citrato de Sildenafila , Sistema Nervoso Simpático/fisiopatologia , Pressão VenosaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Fosfodiesterase/efeitos adversos , Amnésia Global Transitória/induzido quimicamente , Tomografia Computadorizada por Raios XRESUMO
Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.
Assuntos
Síndrome de Guillain-Barré/diagnóstico , Debilidade Muscular/diagnóstico , Doenças Faríngeas/diagnóstico , Insuficiência Respiratória/diagnóstico , Diagnóstico Diferencial , Extremidades , Síndrome de Guillain-Barré/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Músculo Esquelético , Orofaringe , Doenças Faríngeas/etiologia , Insuficiência Respiratória/etiologia , Músculos RespiratóriosRESUMO
Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.
