Mizuguchi Koichi, Hoshino Hideki, Abe Yuichi, Nagasawa Tetsuro, Oka Akira, Kubota Masaya
Division of Neurology, National Center for Child Health and Development, Tokyo.
No To Hattatsu. 2008 Nov;40(6):460-4.
We investigated the usefulness of electrodiagnostic (EDX) studies for the early diagnosis of childhood Guillain-Barré syndrome (GBS). We retrospectively reviewed 5 patients (ages, 17-96 months) who fulfilled the diagnostic criteria of GBS. The EDX studies were performed at least twice;they included 1 or more following:motor nerve conduction study (MNCS), F-wave study, electromyography (EMG), and sensory nerve conduction study. The first and second EDX studies were performed at 8 days (range:4-13 days) and 14 days (range: 12-27 days) after the onset of motor symptoms, respectively. Although only 3 of 5 patients showed abnormal findings in the first MNCS, additional EDX studies, namely, F-wave study and EMG confirmed the presence of peripheral neuropathy in all patients. Regarding the classification of GBS subtypes, the results of the first EDX studies lead to the diagnosis of acute inflammatory demyelinating polyneuropathy (AIDP) in 3 patients and the remaining two were diagnosed with AIDP based on results of the second studies. We concluded that serial EDX studies, including F-wave studies, are essential for the early and definite diagnosis of childhood GBS.
我们研究了电诊断(EDX)检查对儿童吉兰-巴雷综合征(GBS)早期诊断的作用。我们回顾性分析了5例符合GBS诊断标准的患者(年龄17 - 96个月)。EDX检查至少进行了两次,包括以下一项或多项:运动神经传导研究(MNCS)、F波研究、肌电图(EMG)和感觉神经传导研究。首次和第二次EDX检查分别在运动症状出现后的8天(范围:4 - 13天)和14天(范围:12 - 27天)进行。虽然5例患者中只有3例在首次MNCS检查中出现异常结果,但额外的EDX检查,即F波研究和EMG证实所有患者均存在周围神经病变。关于GBS亚型的分类,首次EDX检查结果使3例患者被诊断为急性炎症性脱髓鞘性多发性神经病(AIDP),其余2例根据第二次检查结果被诊断为AIDP。我们得出结论,包括F波研究在内的系列EDX检查对于儿童GBS的早期明确诊断至关重要。