Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
J Neurol Neurosurg Psychiatry. 2011 Mar;82(3):300-5. doi: 10.1136/jnnp.2010.226639. Epub 2011 Jan 26.
In Guillain-Barré syndrome (GBS), the diversity in electrophysiological subtypes is unexplained but may be determined by geographical factors and preceding infections. Acute motor axonal neuropathy (AMAN) is a frequent GBS variant in Japan and one study proposed that in Japan, Campylobacter jejuni infections exclusively elicit AMAN. In The Netherlands C jejuni is the predominant type of preceding infection yet AMAN is rare. This may indicate that not all Dutch GBS patients with C jejuni infections have AMAN.
To determine if GBS patients with a preceding C jejuni infection in The Netherlands exclusively have AMAN.
Retrospective analysis of preceding infections in relation to serial electrophysiology and clinical data from 123 GBS patients. C jejuni related cases were defined as having preceding diarrhoea and positive C jejuni serology. Electrophysiological characteristics in C jejuni related cases were compared with those in viral related GBS patients. In addition, eight GBS patients from another cohort with positive stool cultures for C jejuni were analysed.
17 (14%) of 123 patients had C jejuni related GBS. C jejuni patients had lower motor and higher sensory action potentials compared with viral related cases. Nine (53%) C jejuni patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the criteria for acute inflammatory demyelinating polyneuropathy (AIDP). Also, two (25%) of eight additional patients with a C jejuni positive stool sample had AIDP.
In The Netherlands, C jejuni infections are strongly, but not exclusively, associated with axonal GBS. Some patients with these infections fulfil current criteria for demyelination.
在吉兰-巴雷综合征（GBS）中，电生理学亚型的多样性尚无法解释，但可能由地理因素和前驱感染决定。急性运动轴索性神经病（AMAN）是日本常见的 GBS 变异型，有研究提出，在日本，空肠弯曲菌感染仅引起 AMAN。而在荷兰，空肠弯曲菌是主要的前驱感染类型，但 AMAN 却很少见。这可能表明并非所有荷兰伴有空肠弯曲菌感染的 GBS 患者都患有 AMAN。
确定荷兰伴有空肠弯曲菌前驱感染的 GBS 患者是否均患有 AMAN。
对 123 例 GBS 患者的前驱感染与系列电生理学和临床数据进行回顾性分析。空肠弯曲菌相关病例定义为伴有前驱性腹泻和空肠弯曲菌血清学阳性。比较空肠弯曲菌相关病例的电生理学特征与病毒相关 GBS 患者的电生理学特征。此外，还分析了来自另一队列的 8 例粪便培养空肠弯曲菌阳性的 GBS 患者。
123 例患者中 17 例（14%）存在空肠弯曲菌相关 GBS。与病毒相关病例相比，空肠弯曲菌患者的运动和感觉神经动作电位较低。9 例（53%）空肠弯曲菌患者为 AMAN 或无神经激发。然而，3 例（18%）患者符合急性炎症性脱髓鞘性多发性神经病（AIDP）的标准。此外，8 例空肠弯曲菌粪便样本阳性的患者中，有 2 例（25%）符合 AIDP 标准。
在荷兰，空肠弯曲菌感染与轴索性 GBS 密切相关，但并非完全相关。部分感染患者符合当前脱髓鞘标准。
