title: [A case of polyradiculoneuropathy associated with diffuse arterial narrowing].
abstract: A 32-year-old female was admitted complaining of pain over the whole body and dysesthesia in all extremities. On admission, physical examination revealed hypertension, tachycardia, abdominal distension and urinary retention. Neurological examination revealed sensory impairment over the whole body and mild muscular weakness with absent deep tendon reflexes. Abdominal roentgenogram showed gaseous distension of the bowels. CT scans showed low density areas on the bilateral parieto-occipital lobes. CAG showed diffuse narrowing of the cerebral arteries. Laboratory examinations showed an albumino-cytologic dissociation (cells; 21/3mm, prot.; 78 mg/dl) of the cerebrospinal fluid and increased levels of norepinephrine (214 micrograms/day) and epinephrine (16.1 micrograms/day) in the urine. Motor nerve conduction velocities of the median nerves was 42.8 m/sec in the right and 50.0 m/sec in the left. The autonomic function tests revealed hyper-responsiveness to 10 mg of phentolamine and low baroreflex sensitivity. Within 2 months, most symptoms improved. Repeated CT scans showed no abnormality, while CAG showed only mild arterial narrowing. This case was diagnosed as having acute autonomic and sensory neuropathy which was a subtype of acute polyradiculoneuritis. Occult encephalitis or autonomic dysfunction was considered to contribute to the peculiar findings on CT and CAG.
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D002395:Catecholamines / Q000378:metabolism; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D009431:Neural Conduction; D009475:Neurons, Afferent; D011129:Polyradiculoneuropathy / Q000150:complications*; D012084:Renin-Angiotensin System; D014057:Tomography, X-Ray Computed
chemical_list: D002395:Catecholamines