Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Clin Neurophysiol. 2013 Aug;124(8):1671-9. doi: 10.1016/j.clinph.2013.02.010. Epub 2013 Mar 18.
The exclusive association of Campylobacter jejuni infection with the axonal variant of Guillain-Barré syndrome (GBS) is debatable. The current study aims to elucidate the GBS subtypes of patients with an antecedent C. jejuni infection.
Nerve conduction study results of 73 patients with GBS were reviewed. Patients were defined as having a recent C. jejuni infection when there was a positive stool culture or serological evidence of C. jejuni in the presence of preceding diarrhea.
A total of 23 patients had evidence of a recent C. jejuni infection. At the early stage, patients were classified as AMAN (n=9; 39%), AIDP (n=3; 13%) or equivocal (n=9) using existing electrophysiological criteria. Prolonged distal latencies and conduction slowing that were seen in 11 patients rapidly normalized within 3 weeks in seven, whereas four had minor abnormalities throughout the course. Subsequently, all patients showed either acute motor axonal neuropathy pattern or reversible conduction failure.
Serial neurophysiology suggests that C. jejuni infections are exclusive to axonal GBS.
Our findings suggest that AMAN can demonstrate the full complement of demyelinating features at the early stages of disease.
空肠弯曲菌感染与格林-巴利综合征（GBS）的轴索性变异型之间的排他性关联存在争议。本研究旨在阐明有前驱空肠弯曲菌感染的 GBS 患者的亚型。
回顾了 73 例 GBS 患者的神经传导研究结果。当存在前驱腹泻时，粪便培养阳性或血清中空肠弯曲菌抗体阳性，则定义患者存在近期空肠弯曲菌感染。
共有 23 例患者有近期空肠弯曲菌感染的证据。根据现有的电生理标准，在早期阶段，9 例（39%）患者被分类为急性运动轴索性神经病（AMAN），3 例（13%）患者被分类为急性炎症性脱髓鞘性多发性神经病（AIDP）或不明确，9 例患者。11 例患者出现的延长远端潜伏期和传导减慢在 7 例患者中迅速在 3 周内恢复正常，而 4 例患者在整个病程中均有轻微异常。随后，所有患者均表现为急性运动轴索性神经病或可恢复性传导阻滞。
连续的神经生理学检查提示空肠弯曲菌感染与轴索性 GBS 有关。
我们的发现表明 AMAN 在疾病早期可能表现出脱髓鞘的全部特征。
