A CASE REPORT OF RUBELLA NEUROPATHY

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  • Kobayashi Motohiko
    First Department of Internal Medicine, Showa University School of Medicine
  • Nakanishi Hiroshi
    First Department of Internal Medicine, Showa University School of Medicine
  • Hayashi Yasuo
    First Department of Internal Medicine, Showa University School of Medicine
  • Kunimatsu Shigeo
    First Department of Internal Medicine, Showa University School of Medicine
  • Tohgi Hideo
    First Department of Internal Medicine, Showa University School of Medicine

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Other Title
  • 風疹後に発症したGuillain-Barr陬Qの1例
  • 風疹後に発症したGuillain-Barre症候群の1例
  • フウシンゴ ニ ハッショウシタ Guillain Barreショウコウグン ノ

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Abstract

A 42-year-old female was admitted to the hospital with the complaints of weakness and paresthesia in the four limbs and dysarthria.<BR>Two weeks before admission, she had headaches and chills. Four days later, she had skin rash typical of German measles. Her two daughters also caught German measles during the same period. When her skin rash began to subside, she noticed difficulty in standing up and felt paresthesia in the four extremities, and could not articulate words clearly.<BR>Examination on admission revealed bilateral facial weakness. Muscular strength of the four extremities was reduced, especially in their proximal parts. There were sensory disturbance and parestheia in the distal parts of the limbs. Deep tendon reflexes were absent in the four extremities.<BR>Routine labolatory examinations were within normal limit except moderate elevation of peripheral white blood cell count (10, 000 cells/cmm) . Lumber puncture revealed clear and colorless cerebrospinal fluid under normal pressure, containing 155 mg/cmm of protein and 1 cell/cmm. Haemagglutination inhibition titer for rubella was raised to 1: 516.<BR>She was treated with steroids and began to show improving strength in the extremities. After 80 days, all neurological symptoms disappeared, and cerebrospinal fluid findings returned normal. Haemagglutination inhibition titers for rubella became 256.<BR>Her condition was diagnosed as acute polyradiculoneuritis associated with rubella infection. Previous case reports of rubella neuropathy were reviewed, and the pathogenesis of nerve involvement in rubella was discussed.

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