神经肌肉急症

Q1 Medicine
Catherine S W Albin
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引用次数: 0

摘要

目的:本文旨在让读者熟悉神经肌肉疾病引起的突然发作或急性加重的无力症状患者的临床方法、诊断注意事项和治疗策略:神经肌肉无力通常是炎症过程的结果。近年来,越来越多的人认识到病理抗体会导致神经肌肉损伤。这使临床医生能够做出更准确的诊断。此外,神经肌肉接头紊乱和肌病越来越多地被认为是新型抗癌疗法(即免疫检查点抑制剂)的不良反应。更多数据正在被纳入神经肌肉急症后的神经诊断框架,尤其是针对吉兰-巴雷综合征等常见疾病:护理神经肌肉急症患者需要及时关注呼吸状况。一旦采取了保护气道和促进有效通气的支持性措施,诊断方面的考虑就应以适当的神经定位为基础。免疫介导的神经肌肉疾病通常需要积极的免疫抑制,临床医生必须深思熟虑,根据每位患者的风险因素和合并症选择最适合的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neuromuscular Emergencies.

Objective: This article aims to familiarize the reader with the clinical approach, diagnostic considerations, and treatment strategies for patients presenting with abrupt-onset or acutely worsening weakness due to neuromuscular disorders.

Latest developments: Neuromuscular weakness is often the result of an inflammatory process. In recent years, there has been growing recognition of pathologic antibodies that cause neuromuscular injury. This has allowed clinicians to make a more accurate diagnosis. Additionally, neuromuscular junction disorders and myopathies are increasingly identified as the adverse effects of novel anticancer therapies, namely immune checkpoint inhibitors. More data are being incorporated into frameworks for neuroprognostication after neuromuscular emergencies, especially for commonly encountered disorders such as Guillain-Barré syndrome.

Essential points: Care of patients with neuromuscular emergencies requires prompt attention to respiratory status. Once supportive measures are in place to protect the airway and facilitate effective ventilation, diagnostic considerations should hinge on appropriate neurologic localization. Aggressive immunosuppression is often required for immune-mediated neuromuscular disorders, and clinicians must be thoughtful in selecting a strategy that best aligns with each patient's risk factors and comorbidities.

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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
175
期刊介绍: Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.
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