UTILIZAREA PLASMAFEREZEI ÎN POLIRADICULONEVRITA

Abstract

Polyradiculoneuritis is a fairly rare disease, but with significant neurological impairment, which may even lead to death if not treated in time. However, early and constant treatment has claimed favourable results. Plasmapheresis is an effective etiopathogenetic treatment option for polyradiculoneuritis. Our case is a 50-year-old woman, diagnosed with acute polyradiculoneuritis, Fisher form, who has been conducted five plasmapheresis sessions. Initially, the patient had diplopia, right eyelid ptosis, right facial asymmetry, upper limb paresthesia, distally stressed, limited movements of abduction, abolished tendon reflexes in the lower limbs, ataxia, muscle hypotonia. It was established the diagnosis of acute polyradiculoneuritis based on the clinical picture, in conjunction with the results of NMR (nuclear magnetic resonance) and laboratory tests (blood parameters, cerebrospinal fluid). It was decided to apply plasmapheresis treatment as therapeutic modality, performing the 5 sessions every two days. After the third session, the clinical condition of the patient improved, the motor deficit was in remission, normal coordination. At the end of the five sessions of plasmapheresis, the evolution was favourable, halting progression of neurological deficits, improving the general condition and reducing the limb motor deficit, but maintaining VI and VII cranial nerve paresis. Using plasmapheresis resulted in improved patient dependency and improved quality of life in a shorter period of time as compared to therapy without plasmapheresis results, thus supporting its effectiveness in polyradiculoneuritis. This is precisely why we chose to present this case, although our experience in this regard is relatively recent, for about a year.