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吉兰-巴雷综合征的电诊断与临床特征:142例分析

Electrodiagnostic and clinical aspects of Guillain-Barré syndrome: an analysis of 142 cases.

作者信息

Gupta Deepak, Nair Muraleedharan, Baheti Neeraj N, Sarma P Sankara, Kuruvilla Abraham

机构信息

Department of Neurology and daggerAchutha Menon Centre For Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, Kerala, India.

出版信息

J Clin Neuromuscul Dis. 2008 Dec;10(2):42-51. doi: 10.1097/CND.0b013e31818e9510.

Abstract

BACKGROUND

The incidence of Guillain-Barré syndrome (GBS) and its subtypes varies throughout the world.

OBJECTIVE AND METHODS

We present a retrospective analysis of 142 GBS cases, treated at our center, aimed at classifying GBS electrophysiologically, to study the sequential electrophysiological changes in cases with acute inflammatory demyelinating polyradiculoneuropathy (AIDP), and to look for any clinical and cerebrospinal fluid parameters that can also help in distinguishing the subtypes.

RESULTS

One hundred twenty-one (85.2%) cases had AIDP, 15 (10.6%) had acute motor axonal neuropathy, and 6 (4.2%) were unclassifiable.

CONCLUSIONS

Motor conduction blocks and temporal dispersion could be observed from days 3 and 5 onward, respectively. Progression of motor conduction slowing in AIDP was most impressive in the median nerves. Varying affection of deep tendon reflexes, cranial nerves, and cerebrospinal fluid albuminocytological dissociation can also help make a distinction between AIDP and acute motor axonal neuropathy. Sural sparing, a marker of demyelinating neuropathy, is more commonly seen in later than in early stages of AIDP.

摘要

背景

吉兰 - 巴雷综合征(GBS)及其亚型的发病率在世界各地有所不同。

目的与方法

我们对在本中心接受治疗的142例GBS病例进行了回顾性分析,旨在通过电生理方法对GBS进行分类,研究急性炎症性脱髓鞘性多发性神经根神经病(AIDP)病例的电生理变化顺序,并寻找有助于区分亚型的任何临床和脑脊液参数。

结果

121例(85.2%)为AIDP,15例(10.6%)为急性运动轴索性神经病,6例(4.2%)无法分类。

结论

运动传导阻滞和时限离散分别可在第3天和第5天起观察到。AIDP中运动传导减慢在正中神经最为明显。深腱反射、颅神经的不同受累情况以及脑脊液蛋白细胞分离也有助于区分AIDP和急性运动轴索性神经病。腓肠神经保留作为脱髓鞘性神经病的一个指标,在AIDP后期比早期更常见。

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