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Hong Sunmok,Jeon Jihui,Chang Won Kee 대한근전도전기진단의학회 2023 대한근전도 전기진단의학회지 Vol.25 No.1
Cranial neuropathy and radiculopathy are common complications of tuberculous meningitis. However, the co-occurrence of these complications and the corresponding electrodiagnostic findings have rarely been reported. We report a patient diagnosed with tuberculous meningitis who presented with difficulty in smelling, facial paralysis, hearing loss, and severe weakness in the bilateral lower extremities. A neurological examination confirmed impaired function of the olfactory nerves. Electrodiagnostic studies, including a nerve conduction study, electromyography, and brainstem auditory evoked potential, revealed multiple cranial neuropathies involving the left facial nerve and bilateral vestibulocochlear nerves, as well as bilateral lumbosacral polyradiculopathies. In patients with tuberculous meningitis, multiple cranial neuropathies and polyradiculopathies can occur simultaneously as complications, and electrodiagnostic studies can enable an accurate diagnosis of these complications and an assessment of their severity.
Hong Sunmok,Park Seoyeong,Lee Yeji,Lee Ryeojin,Hyun Sung Eun 대한근전도전기진단의학회 2023 대한근전도 전기진단의학회지 Vol.25 No.1
Patients diagnosed with Japanese encephalitis (JE) may present with flaccid paralysis. JE has also been reported to be accompanied by anterior horn cell disease or motor axonal polyneuropathy. We report a case of a patient with JE with prolonged limb and respiratory muscle weakness who underwent electrodiagnostic studies, including a phrenic nerve conduction study, 10 months after the onset of paralysis. During that 10-month period, severe weakness of the upper and lower extremities showed no recovery, and the patient required long-term ventilator support through a tracheostomy. Nerve conduction studies and electromyography revealed chronic anterior horn cell disease with abundant denervation potentials involving the craniobulbar, cervical, thoracic, and lumbosacral segments. In addition to the nerves in the upper and lower extremities, the phrenic motor nerves showed abnormalities indicative of diaphragmatic weakness. Therefore, in patients with JE with chronic limb weakness and respiratory difficulty, thorough electrodiagnostic studies should be performed to diagnose the combination of anterior horn cell disease with encephalitis and to evaluate the condition’s severity and prognosis.