米勒-费舍尔综合征延迟性面瘫通过类固醇疗法迅速缓解

IF 0.9
Journal of medical cases Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI:10.14740/jmc4305
Nithisha Thatikonda, Alexandru Lerint, Vijaya Valaparla, Chilvana Patel
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引用次数: 0

摘要

米勒-费舍尔综合征(MFS)是格林-巴利综合征(GBS)的一种变异型,其特征是共济失调、等反射和眼肌麻痹的典型三联征。约 20% 的 MFS 患者会出现面部无力,其中一部分患者会在其他神经系统症状达到顶峰或开始好转后出现迟发性面瘫(DFP)。最初,DFP 被认为是 MFS 的自然发展,因此建议患者不要接受额外的治疗。然而,一些患者在未接受额外治疗的情况下,DFP持续了50多天,这促使患者接受额外的类固醇治疗,从而加快了DFP的缓解。我们描述了一名出现 MFS 典型三联征并随后发展为 DFP 的 MFS 患者。该患者接受了甲基强的松龙脉冲疗法(1000 毫克/天,持续 3 天),随后口服强的松龙(60 毫克/天)并逐渐减量,结果 DFP 迅速完全消退,这表明 DFP 的背后存在另一种机制,为进一步研究和深入了解这一问题开辟了途径。文献中很少有 MFS-DFP 的报道。除了本病例之外,我们还旨在提供有关 MFS-DFP 的全面文献综述,以进一步扩展有关 DFP-MFS 现有概念的现有知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rapid Resolution of Delayed Facial Palsy in Miller Fisher Syndrome With Steroid Therapy.

Miller Fisher syndrome (MFS), a variant of Guillain-Barre syndrome (GBS), is characterized by the classic triad of ataxia, areflexia, and ophthalmoplegia. Approximately 20% of MFS patients experience facial weakness, with a subset developing delayed facial palsy (DFP) after other neurological symptoms have peaked or begun to improve. Initially, DFP was considered a natural progression of MFS, leading to recommendations against additional treatment. However, DFP persisted for more than 50 days without additional treatment in some patients, prompting additional steroid therapy, resulting in quicker resolution of DFP. We describe an MFS patient who presented with the classic triad of MFS and subsequently developed DFP. The patient was treated with methylprednisolone pulse therapy (1,000 mg/day for 3 days) followed by oral prednisolone (60 mg/day) with a gradual taper, resulting in rapid and complete resolution of DFP, suggesting an alternative mechanism behind DFP, opening avenues for further research and insights into this matter. MFS-DFP is rarely reported in the literature. In addition to this case, we aim to provide a comprehensive literature review on MFS-DFP, to further expand the existing knowledge on the current concepts of DFP-MFS.

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