PDF(Pubmed)
Abstract：
Peripheral neuropathies, especially those with atypical features, remain a diagnostic challenge. In this case, a 60-year-old patient presented with acute-onset weakness starting in the right hand then sequentially involving the left leg, left hand, and right leg over 5 days. The asymmetric weakness was accompanied by persistent fever and elevated inflammatory markers. Subsequent development of rashes combined with careful review of the history led us to the final diagnosis and targeted treatment. This case highlights clinical pattern recognition with the help of electrophysiologic studies in peripheral neuropathies, which provide shortcuts to narrow the differential diagnosis. We also illustrate the important pitfalls from history taking to ancillary testing in diagnosing the rare but treatable cause of peripheral neuropathy (eFigure 1, links.lww.com/WNL/C541).
摘要：
周围神经病变,尤其是那些具有非典型特征的人，仍然是诊断挑战。在这种情况下,一名60岁的患者出现急性发作无力，从右手开始，然后依次累及左腿，左手,和右腿超过5天。不对称无力伴有持续发烧和炎症标志物升高。随后的皮疹发展以及对病史的仔细回顾使我们得以最终诊断和针对性治疗。该病例在周围神经病变的电生理研究的帮助下突出了临床模式识别，这提供了缩小鉴别诊断范围的捷径。我们还说明了从病史到辅助测试在诊断罕见但可治疗的周围神经病变原因中的重要陷阱（eFigure1，链接。www.com/WNL/C541)。
