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首页> 外文期刊>Advanced studies in medicine >Acute weakness: A practical step-by-step approach to distinguishing myelopathy from neuropathy
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Acute weakness: A practical step-by-step approach to distinguishing myelopathy from neuropathy

机译：急性衰弱：一种实用的循序渐进方法，可将骨髓病与神经病区分开

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PURPOSE: The primary care clinician may on occasion need to evaluate the patient who presents with acute or insidious weakness, which may be as a result of a myelopathy or neuropathy. The purpose of this article is to review a step-by-step practical approach to the diagnosis and treatment of these conditions based on available data and expert opinion. EPIDEMIOLOGY: Guillain-Barre syndrome is the most common type of acute neuropathy presenting with weakness or paralysis, and affects 10 to 20 individuals per million in the United States. Acute weakness secondary to spinal cord injury (myelopathy) is uncommon (32 cases per million population), but its impact on the individual, his family, and society are significant. REVIEW SUMMARY: This review highlights the various conditions that may result in a presentation of an acute neuropathy or myelopathy, and provides criteria to distinguish between them. A practical algorithm is provided, allowing the clinician, guided by key historical questions and data from the physical examination, laboratory, and neuroimaging studies, to determine probable underlying etiologies and initiate proper treatment in a timely fashion. TYPE OF AVAILABLE EVIDENCE: Systematic reviews, randomized, controlled trials, cohort studies, case reports, unstructured reviews, and textbooks. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Although not every acute myelopathy has a clearly established treatment, the available evidence suggests that appropriate classification and treatment of patients with acute myelopathies eliminates unnecessary testing and can improve outcomes. Recent studies have identified key predictors of recovery in certain forms of myelopathy and ongoing studies are attempting to define diagnostic strategies that appropriately classify and prognosticate outcomes in patients with myelopathies.
机译：目的：初级保健临床医生有时可能需要评估由于脊髓病或神经病而出现急性或阴茎无力的患者。本文的目的是根据现有数据和专家意见，回顾逐步诊断和治疗这些疾病的实用方法。流行病学：格林-巴利综合征是最常见的急性神经病，表现为无力或麻痹，在美国每百万人口中有10至20个人受到影响。继发于脊髓损伤（脊髓病）的急性无力并不常见（每百万人口32例），但它对个人，家庭和社会的影响却很大。综述：这篇综述重点介绍了可能导致急性神经病或脊髓病表现的各种疾病，并提供了区分这些疾病的标准。提供了一种实用的算法，使临床医生可以在关键历史问题和来自体格检查，实验室和神经影像学研究的数据的指导下，确定可能的潜在病因并及时采取适当的治疗措施。可用的证据类型：系统评价，随机对照试验，队列研究，病例报告，非结构性评价和教科书。可用的证据等级：很好。结论：尽管并非每种急性脊髓病都有明确的治疗方法，但现有证据表明，对急性脊髓病患者进行适当的分类和治疗可以消除不必要的检查并改善结果。最近的研究已经确定了某些形式的脊髓病恢复的关键预测因子，正在进行的研究正在试图确定诊断策略，以适当地分类和预后骨髓病患者的预后。

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