Division of Neuropediatrics and Muscular Disorders, Department of Pediatrics and Adolescent Medicine, University Medical Center and Medical Faculty, University of Freiburg, Freiburg, Germany.
Present (private) address: Gutleutstr. 21, 79115, Freiburg, Germany.
J Peripher Nerv Syst. 2020 Dec;25(4):344-349. doi: 10.1111/jns.12411. Epub 2020 Sep 18.
Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy frequently preceded by an infection with Campylobacter jejuni or nonspecific infections, and rarely by a vaccination. Due to a lack of a pathognomonic finding or biomarker, its diagnosis is based on a typical constellation of clinical and paraclinical symptoms and findings. The Brighton Collaboration GBS Working Group published in 2011 GBS case definitions and guidelines for diagnosis to improve the registration of GBS cases occurring in conjunction with vaccination programs worldwide. We applied these criteria to two historical studies on GBS in children and adolescents performed retrospectively from 1989 to 1994 and prospectively from 1998 to 2002. The clinical criteria were met in 91% of the retrospective and all of the prospective cases. CSF investigations were conducted in all patients and revealed cytoalbuminologic dissociation in 80% of the retrospective and 75% of the prospective cohort. Nerve conduction studies were performed in 61% and 69% of the cohorts, respectively, and were pathological in 92% each. The Brighton criteria are well suited to capture GBS in retro- and prospective studies. However, because they are designed to diagnose classical symmetric and ascending GBS and Fisher syndrome, very rare topographical variants of GBS such as the pharyngo-cervico-brachial variant and others could be missed.
格林-巴利综合征（GBS）是一种免疫介导的多神经根神经病，常由空肠弯曲菌感染或非特异性感染引起，很少由疫苗接种引起。由于缺乏特征性发现或生物标志物，其诊断基于典型的临床和辅助临床症状和发现的组合。布莱顿合作组织 GBS 工作组于 2011 年发布了 GBS 病例定义和诊断指南，以改善全球疫苗接种计划中发生的 GBS 病例的登记。我们将这些标准应用于两项对儿童和青少年 GBS 的历史研究，这些研究是在 1989 年至 1994 年回顾性进行的，在 1998 年至 2002 年前瞻性进行的。在回顾性病例中，91%符合临床标准，前瞻性病例中全部符合临床标准。所有患者均进行了脑脊液检查，在回顾性队列中，80%和前瞻性队列中 75%的患者出现细胞白蛋白分离。神经传导研究分别在 61%和 69%的队列中进行，每个队列的病理结果均为 92%。布莱顿标准非常适合捕捉回顾性和前瞻性研究中的 GBS。然而，由于它们旨在诊断典型的对称和上升性 GBS 和费舍尔综合征，因此可能会错过非常罕见的 GBS 拓扑变体，如咽颈臂变体和其他变体。
