Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
Muscle Nerve. 2011 Jun;43(6):807-11. doi: 10.1002/mus.21990.
Flaccid quadriparesis is a common neurological problem. Guillain-Barré syndrome Guillain-Barre syndrome (GBS), polymyositis/dermatomyositis (PM/DM), generalized myasthenia gravis (MG), and hypokalemic periodic paralysis (HPP) constitute the majority of cases of flaccid quadriparesis. Few patients from any of these disease groups lack the cardinal clinical features. We established clinical marker(s) that might have significant discriminating power for diagnosis.
Forty-six patients satisfied all of our criteria. Cases were evaluated clinically followed by laboratory and electrophysiological study, and, in selected cases, muscle histopathology.
Twenty-four patients had GBS, 9 had MG, 7 had PM/DM, and 6 had HPP. Jaw-opening weakness was found in 71.4% of PM/DM, 83.3% of HPP, and 4.1% of GBS cases. Jaw-closing weakness was found in 88.8% of MG cases.
Presence of jaw-closing weakness pointed toward MG, whereas presence of jaw-opening weakness suggested muscle disease (PM/DM and HPP). GBS patients very rarely had jaw muscle weakness.
弛缓性四肢瘫痪是一种常见的神经系统问题。格林-巴利综合征（GBS）、多发性肌炎/皮肌炎（PM/DM）、全身性重症肌无力（MG）和低钾性周期性瘫痪（HPP）构成了弛缓性四肢瘫痪的大多数病例。这些疾病组中的极少数患者缺乏主要的临床特征。我们确定了一些临床标志物，这些标志物可能具有重要的诊断鉴别能力。
46 名患者符合我们的所有标准。对病例进行临床评估，然后进行实验室和电生理研究，并在选定的病例中进行肌肉组织病理学检查。
24 名患者患有 GBS，9 名患者患有 MG，7 名患者患有 PM/DM，6 名患者患有 HPP。71.4%的 PM/DM 患者、83.3%的 HPP 患者和 4.1%的 GBS 患者存在张口无力。88.8%的 MG 患者存在闭口无力。
存在闭口无力提示为 MG，而存在张口无力提示为肌肉疾病（PM/DM 和 HPP）。GBS 患者很少出现咀嚼肌无力。
