A Case of Acute Autonomic and Sensory Neuropathy
Accompanied by Respiratory Failure

J Korean Neurol Assoc > Volume 17(5); 1999 > Article

Journal of the Korean Neurological Association 1999;17(5): 752-756.

호흡 부전을 동반한 급성 자율-감각신경병증 1예

박경필, 안규환 김은주 김대성 정대수 박규현 김매자*

부산대학교 의과대학 신경과학교실,울산병원 내과*

A Case of Acute Autonomic and Sensory Neuropathy Accompanied by Respiratory Failure

Kyung-Pil Park, M.D., Kyu-Hwan An, M.D., Eun-Joo Kim, M.D., Dae-Seong Kim, M.D., Dae-Soo Jung, M.D., Kyu-Hyun Park, M.D., Mae-Ja Kim, M.D.*

Department of Neurology, Pusan National University of Medicine, Department of Internal medicine, Ulsan Hospital*

Abstract

Acute autonomic and sensory neuropathy (AASN) is a rare neuropathy characterized by the acute onset of autonomic dysfunction and objective sensory disturbances. A 33-year-old woman experienced generalized fatigue, urinary reten-tion, and defecation difficulty with numbness around her mouth followed by a decreased pain sensation over her face and whole body, and respiratory difficulty with aspiration pneumonia. Neurological examination revealed bilaterally dilated fixed pupils, loss of sweating and lacrimation, orthostatic hypotension, and decreased sensation of all modalities with transient mild to moderate motor weaknesses. The muscle weakness may have been responsible for her respiratory failure as her respiratory distress was resolved in conjunction with improved general muscle power. Although the pathogenetic mechanism of AASN has been generally believed to be immune-mediated, the absence of immunoglobu-lin responsiveness and the negative results to various autoantibody tests in our case, raises questions against its autoim-mune etiology. The patient showed slow progress of overcoming her autonomic dysfunction with relatively persistent sensory deficits. J Kor Neurol Ass 17(5):752~756, 1999 Key Words : Acute autonomic and sensory neuropathy, Respiratory failure