Internal Medicine

hayashi kazutaka

  (林 和孝)

Profile Information

Affiliation
Fujita Health University
Degree
学士(医学)(藤田保健衛生大学)

J-GLOBAL ID
201901014838469805
researchmap Member ID
7000029418

Research Areas

 1

Papers

 1
  • Yasuaki Mizutani, Shunsuke Adachi, Shoko Nakano, Kazutaka Hayashi, Atsuhiro Higashi, Kouichi Kikuchi, Toshiki Maeda, Kenichiro Murate, Sayuri Shima, Takahiro Iizuka, Akihiro Ueda, Mizuki Ito, Hirohisa Watanabe
    AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL, 237 102910-102910, Jan, 2022  
    Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a severe form of stiff-person spectrum disorder. We report a 59-year-old man who presented with progressive encephalomyelitis causing diplopia, bulbar palsy, severe dysautonomia, followed by stiffness and myoclonic cluster. Laboratory tests showed mild pleocytosis, with markedly elevated plasma levels of norepinephrine, epinephrine, and arginine vasopressin. Glycine-receptor antibodies were identified in both serum and CSF. Despite a poor response to methylprednisolone, immunoglobulins, and plasma exchange, α-blocker stabilized dysautonomia. Dysautonomia is presumed to be due to antibody-mediated disinhibited sympathetic hyperactivity; however, this case suggests that concomitant use of α-blocker with immunotherapy may ameliorate dysautonomia.