Ramachandran Rajesh, Kuruvilla Abraham
Medical College, Calicut.
J Indian Med Assoc. 2004 Sep;102(9):480-2, 484, 486.
In this study, 55 cases of Guillain-Barre syndrome (GBS) in children and adolescents of 2-18 years of age were analysed retrospectively to study the clinical profile and to evaluate the prognostic value of reduced compound muscle action potential (CMAP) on the need for ventilation and functional outcome. Of the 28 boys and 27 girls 87.3% were bed-bound at peak deficit. Other features were as follows: Bifacial weakness-75%, bulbar weakness-56.4%, need for assisted ventilation-41.8% and albuminocytological dissociation-65.9%. In the ventilated and non-ventilated group no difference was noted in the incidence of reduced CMAP amplitude (p-value > 0.5). At 3 months 83.3% and at 6 months 80.8% cases were ambulant with support. Reduced CMAP amplitude of less than 20% of the lower limit of the normal in at least 2 nerves did not predict the need for ventilation or the chance of independent walking at 3 or 6 months.
在本研究中,对55例2至18岁儿童及青少年吉兰-巴雷综合征(GBS)患者进行回顾性分析,以研究其临床特征,并评估复合肌肉动作电位(CMAP)降低对通气需求及功能转归的预后价值。28名男孩和27名女孩中,87.3%在肌无力高峰时需卧床。其他特征如下:双侧面瘫75%,延髓肌无力56.4%,需辅助通气41.8%,蛋白细胞分离65.9%。在通气组和非通气组中,CMAP波幅降低的发生率无差异(p值>0.5)。3个月时83.3%的病例、6个月时80.8%的病例在辅助下可行走。至少2条神经的CMAP波幅降低至正常下限的20%以下,并不能预测通气需求或3个月及6个月时独立行走的可能性。