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[A case of polyradiculoneuropathy associated with diffuse arterial narrowing]
No to Shinkei = Brain and Nerve
|August 1, 1986
Summary
This case study highlights acute autonomic and sensory neuropathy, a rare neurological disorder. Prompt diagnosis and management led to significant symptom improvement in a 32-year-old female patient.
Area of Science:
- Neurology
- Autonomic Nervous System Disorders
- Polyradiculoneuritis
Background:
- Acute autonomic and sensory neuropathy is a rare subtype of acute polyradiculoneuritis.
- It presents with a constellation of autonomic, sensory, and motor deficits.
Observation:
- A 32-year-old female presented with widespread pain, dysesthesia, hypertension, tachycardia, abdominal distension, urinary retention, sensory impairment, and muscle weakness.
- Cerebral CT scans revealed low-density lesions in the parieto-occipital lobes, and cerebral angiography (CAG) showed diffuse cerebral artery narrowing.
- Cerebrospinal fluid analysis demonstrated albumino-cytologic dissociation, and urine tests showed elevated norepinephrine and epinephrine levels.
Findings:
- Nerve conduction studies indicated reduced motor nerve velocities.
- Autonomic function tests revealed hyper-responsiveness to phentolamine and low baroreflex sensitivity.
- The patient was diagnosed with acute autonomic and sensory neuropathy, with potential contributions from occult encephalitis or autonomic dysfunction.
Implications:
- This case underscores the importance of recognizing acute autonomic and sensory neuropathy, even with atypical neuroimaging findings.
- Early diagnosis and supportive care can lead to substantial recovery.
- Further research into the pathophysiology of this condition is warranted.