Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan.
Neurol Sci. 2011 Dec;32(6):1219-22. doi: 10.1007/s10072-011-0708-z. Epub 2011 Jul 22.
Ophthalmoparesis in cytomegalovirus (CMV)-associated Guillain-Barré syndrome (GBS) is rare. We treated a 37-year-old woman with CMV-GBS who presented with an acute onset of generalized weakness and numbness in the extremities, followed by facial diplegia, which led to mechanical ventilation. She had increased IgM and IgG-type antibodies against CMV in the serum and increased IgM-type serum anti-GM2 ganglioside antibody was also noted, whereas anti-GQ1b ganglioside antibody was not found. She then developed the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). After recovery of consciousness due to SIADH, she exhibited bilateral abducens palsy, together with the recurrence of limb weakness and facial diplegia. Her neurological signs gradually recovered after high-dose intravenous administrations of immunoglobulin. CMV infection should be listed in the differential diagnosis of GBS patients who present with ophthalmoparesis.
巨细胞病毒（CMV）相关格林-巴利综合征（GBS）合并眼肌麻痹较为罕见。我们治疗了一位 37 岁女性 CMV-GBS 患者，她表现为四肢进行性无力和麻木，随后出现面瘫，需要机械通气。患者血清中 CMV 的 IgM 和 IgG 型抗体升高，且血清 IgM 型抗 GM2 神经节苷脂抗体升高，而抗 GQ1b 神经节苷脂抗体未见升高。之后患者发生抗利尿激素分泌不当综合征（SIADH）。由于 SIADH 恢复意识后，患者出现双侧展神经麻痹，伴有四肢无力和面瘫复发。大剂量静脉注射免疫球蛋白后，患者的神经症状逐渐恢复。CMV 感染应列入出现眼肌麻痹的 GBS 患者的鉴别诊断中。
