ギランバレーは何例かみました。
キャンピロバクターが有名ですね。
・Guillain-Barré syndrome is an acute monophasic paralyzing illness, which manifests as with ascending paralysis 2–4 weeks after a respiratory or gastrointestinal illness.
Invasion by activated T lymphocytes is followed by macrophage-mediated demyelination, with evidence of complement and immunoglobulin deposition on myelin and Schwann cells.
ギランバレーは急性上行性の麻痺。呼吸器、消化器感染から2−4週間。
マクロファージによる脱髄でTリンパ球活性。
上肢メインはFisher。
呼吸筋麻痺、致死的不整脈に注意。
・There are five conditions that must be met to make a diagnosis for delayed wake-sleep phase disorder:
・A sleep log is used
・Sleep symptom disturbances have been present for at least 3 months
・Patient has no other current sleep disorders
・Patient has no history of neurologic disorders
・Patient has no mental or substance use disorders.
睡眠相後退症候群は少なくても3ヶ月持続。その他疾患除外。
・Neurologic examination reveals intact vision and a narrowed right palpebral fissure. A posteroanterior chest radiograph shows a right apical opacity.
・パンコースト腫瘍→ホルネル症候群
頸部交感神経の出力機能障害により眼瞼下垂，縮瞳，および無汗症が生じる病態である。
交感神経の圧迫→交感神経症状低下
患側の縮瞳
発汗は交感神経（アセチルコリン作動性）
・The cerebrocerebellum (or neocerebellum) includes the lateral hemispheres of the cerebellum, which function in motor planning and complex coordination.
Lesions of the cerebrocerebellum typically present with dysdiadochokinesia (inability to perform rapid, alternating movements) and intention tremor (broad, coarse tremor that worsens as visually guided movements reach their endpoint).
小脳失調の症状。
・dysdiadochokinesia拮抗運動反復不全；素早い動きや方向転換がしにくい。
・intention tremor
・Thiamine deficiency is common in alcoholics due to poor nutritional intake, and it presents as Wernicke encephalopathy. This condition involves a triad of symptoms: ophthalmoplegia or nystagmus, ataxia, and encephalopathy.
This patient does not have the confusion or ocular symptoms associated with Wernicke encephalopathy.
チアミン欠乏は飲酒している方ではコモン。
ウェルニッケの3兆は眼球運動障害、失調、脳症。
