[非典型肌萎缩性脊髓侧索硬化症(Vulpian-Bernhardt 综合征)的电诊断支持]。

Crhistian Alejandro Aguilar-Vázquez, Sergio de Jesús Aguilar-Castillo, Alejandra Diana Raymundo-Carrillo
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摘要

背景介绍武尔皮安-伯恩哈德综合征是运动神经元疾病的一种非典型形式,早在 19 世纪就有描述。及时诊断的重要性在于这种变异型的存活率更高。由于该病临床罕见且诊断复杂,我们报告了一例该病的临床病例,因此我们描述了该病的典型临床表现和诊断方法,并对这种神经退行性疾病进行了文献综述:临床病例:拉美裔男子,其临床病例的起病特点是胸廓不对称和肢体无力,并从上肢远端向近端逐渐加重。随后,症状加重,限制了患者的日常活动,影响了其身体的独立性。体格检查结果与运动神经元疾病一致。进行了神经传导检查,结果证实运动神经元受累仅限于胸肢:结论:Vulpian-Bernhardt 综合征是一种不常见的运动神经元疾病。结论:Vulpian-Bernhardt 综合征是一种不常见的运动神经元疾病,由于其表现形式罕见,即使是训练有素的医生也经常混淆其临床表现。电诊断的重要性在于确定疾病的神经源,以及主动去神经支配和再神经支配数据。考虑到与典型的肌萎缩性脊髓侧索硬化症相比,该综合征患者的存活期更长,因此必须有明确的诊断方法,以提供更好的生活质量和支持性治疗。
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[Electrodiagnostic support in an atypical form of amyotrophic lateral sclerosis (Vulpian-Bernhardt syndrome)].

Background: Vulpian-Bernhardt syndrome is an atypical form of the motor neuron disease described since the 19th century. The importance of a timely diagnosis lies in the increased survival present in this variant. Due to the clinical rarity and complex diagnosis we report a clinical case of this disease, which is why we describe the typical clinical presentation, the diagnostic approach, and we make a bibliographic review of this neurodegenerative disorder as well.

Clinical case: Latin American man whose clinical case onset was characterized by thoracic asymmetric and increasing limb weakness, showing affection from distal to proximal upper limbs area. Subsequently, symptoms worsened to the point of limiting day-to-day activities and conditioning patient's physical independence. Physical examination was consistent with motor neuron disease. Nerve conduction studies were performed and confirmed findings compatible with motor neuron involvement limited to thoracic limbs.

Conclusion: Vulpian-Bernhardt syndrome is an uncommon form of motor neuron disease. Due to the rarity of its presentation, it is frequent to confuse clinical profile even for trained physicians. The importance of electrodiagnosis relies in identifying the neurogenic origin of the disease, as well as the active denervation and reinnervation data. Considering that with this syndrome patients have a longer survival than with the classic form of amyotrophic lateral sclerosis, it is important to have a clear diagnosis approach in order to provide a better quality of life and supportive treatment.

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