Tellier S, Gerdelat-Mas A, Karsenty C, Cancès C, Tison C, Chaix Y, Cheuret E
Service de neurologie pédiatrique, hôpital des enfants, CHU de Toulouse, 330, avenue Grande-Bretagne, 31059 Toulouse cedex 9, France.
Arch Pediatr. 2012 Jan;19(1):51-4. doi: 10.1016/j.arcped.2011.10.021. Epub 2011 Dec 9.
We describe the case of a 10-year-old child with the acute motor axonal neuropathy (AMAN) form of Guillain-Barré syndrome (GBS) with preserved tendon reflexes, 6 days after a bout of gastroenteritis. The child quickly showed weakness of the distal muscles of his four limbs, with preserved tendon reflexes and a raised CSF protein concentration with no cells. Nerve conduction studies showing motor axonal degeneration confirmed the diagnosis of GBS in spite of preserved tendon reflexes. The serum was positive for IgG antibodies to gangliosides GM1 and GD1b. The child received intravenous immunoglobulins, which resulted in a favorable progression. This case proves that GBS with normal tendon reflexes exists. The other cases of SGB with preserved tendon reflexes already described in the literature were the AMANs form with antibodies to gangliosides in the serum and only adults were affected.
我们描述了一例10岁儿童的病例,该患儿在患肠胃炎6天后出现吉兰-巴雷综合征(GBS)的急性运动轴索性神经病(AMAN)形式,其腱反射保留。患儿迅速出现四肢远端肌肉无力,腱反射保留,脑脊液蛋白浓度升高且无细胞。神经传导研究显示运动轴索变性,尽管腱反射保留,但仍确诊为GBS。血清中抗神经节苷脂GM1和GD1b的IgG抗体呈阳性。患儿接受了静脉注射免疫球蛋白治疗,病情进展良好。该病例证明存在腱反射正常的GBS。文献中已描述的其他腱反射保留的SGB病例为血清中存在抗神经节苷脂抗体的AMAN形式,且仅累及成年人。