[A case of acute polyradiculoneuropathy following measles infection]

A 39-year-old man was admitted to our hospital because of diplopia, dysphagia, tetraparesis and urinary incontinence which developed six days after fever and general cutaneous rash had appeared. On neurological examination, total ophthalmoplegia, blepharoptosis, facial nerve palsy, bulbar palsy, and tetraparesis were observed, and the deep tendon reflexes were hypoactive or absent. The cerebrospinal fluid (CSF) showed albumin-cytological dissociation. serial complement fixation tests and enzyme-linked immunosorbent assays showed an elevation of antibody titers to measles virus in sera and CSF including serum IgM antibody. On the basis of findings, we diagnosed him as acute polyradiculoneuropathy following measles infection. After 3 sessions of immunoadsorption plasmapheresis his symptoms improved promptly. Marked improvement by immunoadsorption plasmapheresis suggested that immune-mediated mechanisms were involved in the pathogenesis of acute polyradiculoneuropathy following measles infection.