© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. CASE DESCRIPTION A 26yearold woman presented with low back pain, perineal numbness, double incontinence and numbness involving her distal upper and lower limbs, with mild weakness of both legs. These symptoms followed a 3week history of gastrointestinal illness. On neurological examination, there was weakness (Medical Research Council grade 4/5) of finger abduction and in proximal and distal leg muscles. Deep tendon reflexes were absent in both legs but normal in the arms. Pinprick sensation was diminished in the saddle area and the feet, with loss of vibration sense in the feet. MR scan of lumbar spine showed diffuse enhancement of all nerve roots in the cauda equina (figure 1). Cerebrospinal fluid (CSF) was acellular with elevated protein at 1.42 g/L (0.12–0.45). Nerve conduction studies, performed 4 weeks after symptoms onset, found prolonged distal latencies in the upper and lower limbs, with dispersed responses from common peroneal nerves. Fwave latencies were prolonged in the median nerve and prolonged or absent in the legs. Sensory studies in median, superficial peroneal and sural were normal; needle examination of the tested muscles was normal, including the anal sphincter. Her symptoms improved following intravenous immunoglobulin and at 3 months the MR scan findings had gradually resolved.

中文翻译：

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格林-巴利综合征的神经根增强

© 作者（或其雇主）2021。不得用于商业用途。请参阅权利和许可。由英国医学杂志出版。病例描述 一名 26 岁女性，表现为腰痛、会阴部麻木、双侧大小便失禁和双下肢远端麻木，双腿轻度无力。这些症状是在 3 周的胃肠道疾病史之后出现的。在神经系统检查中，手指外展和近端和远端腿部肌肉无力（医学研究委员会 4/5 级）。双腿无深腱反射，但手臂正常。鞍区和足部的针刺感减弱，足部失去振动感。腰椎 MR 扫描显示马尾所有神经根弥漫性强化（图 1）。脑脊液 (CSF) 是无细胞的，蛋白质升高为 1.42 g/L (0.12-0.45)。症状发作 4 周后进行的神经传导研究发现，上肢和下肢远端潜伏期延长，腓总神经反应分散。正中神经的 F 波潜伏期延长，而腿部的 F 波潜伏期延长或消失。中位、腓浅和腓肠的感觉检查正常；被测肌肉的针头检查正常，包括肛门括约肌。静脉注射免疫球蛋白后她的症状有所改善，并且在 3 个月时，MR 扫描结果逐渐消失。正中神经的 F 波潜伏期延长，而腿部的 F 波潜伏期延长或消失。中位、腓浅和腓肠的感觉检查正常；被测肌肉的针头检查正常，包括肛门括约肌。静脉注射免疫球蛋白后她的症状有所改善，并且在 3 个月时，MR 扫描结果逐渐消失。正中神经的 F 波潜伏期延长，而腿部的 F 波潜伏期延长或消失。中位、腓浅和腓肠的感觉检查正常；被测肌肉的针头检查正常，包括肛门括约肌。静脉注射免疫球蛋白后她的症状有所改善，并且在 3 个月时，MR 扫描结果逐渐消失。