ABSTRACT
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%.
Subject(s)
Back Pain/etiology , Nerve Sheath Neoplasms/diagnosis , Neurofibromatosis 1/diagnosis , Neurofibromatosis 1/surgery , Thoracic Neoplasms/diagnosis , Adult , Diagnosis, Differential , Diagnostic Imaging , Female , Humans , Nerve Sheath Neoplasms/surgery , Thoracic Neoplasms/surgeryABSTRACT
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.
Subject(s)
Humans , Male , Middle Aged , Guillain-Barre Syndrome/diagnosis , Muscle Weakness/diagnosis , Pharyngeal Diseases/diagnosis , Respiratory Insufficiency/diagnosis , Diagnosis, Differential , Extremities , Guillain-Barre Syndrome/complications , Muscle, Skeletal , Muscle Weakness/etiology , Oropharynx , Pharyngeal Diseases/etiology , Respiratory Muscles , Respiratory Insufficiency/etiologySubject(s)
Amnesia, Transient Global/etiology , Coitus , Phosphodiesterase 5 Inhibitors/adverse effects , Piperazines/adverse effects , Sulfonamides/adverse effects , Vasodilator Agents/adverse effects , Cerebral Veins/physiopathology , Coitus/physiology , Hippocampus/blood supply , Humans , Male , Middle Aged , Neuroimaging , Purines/adverse effects , Sildenafil Citrate , Sympathetic Nervous System/physiopathology , Venous PressureABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Phosphodiesterase Inhibitors/adverse effects , Amnesia, Transient Global/chemically induced , Tomography, X-Ray ComputedABSTRACT
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.
Subject(s)
Guillain-Barre Syndrome/diagnosis , Muscle Weakness/diagnosis , Pharyngeal Diseases/diagnosis , Respiratory Insufficiency/diagnosis , Diagnosis, Differential , Extremities , Guillain-Barre Syndrome/complications , Humans , Male , Middle Aged , Muscle Weakness/etiology , Muscle, Skeletal , Oropharynx , Pharyngeal Diseases/etiology , Respiratory Insufficiency/etiology , Respiratory MusclesABSTRACT
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.
