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病例报告:吉兰-巴雷综合征继发颅内高压

Case Report: Intracranial Hypertension Secondary to Guillain-Barre Syndrome.

作者信息

Doxaki Christina, Papadopoulou Eleftheria, Maniadaki Iliana, Tsakalis Nikolaos G, Palikaras Konstantinos, Vorgia Pelagia

机构信息

Department of Pediatrics, University General Hospital of Heraklion, Crete, Greece.

Department of Ophthalmology, University General Hospital of Heraklion, Crete, Greece.

出版信息

Front Pediatr. 2021 Jan 20;8:608695. doi: 10.3389/fped.2020.608695. eCollection 2020.

Abstract

Guillain-Barre Syndrome (GBS), a common cause of acute flaccid paralysis, is characterized by a rapidly progressive, usually symmetric weakness of the extremities. Headache and intracranial hypertension (ICHT) are very rare complications of GBS. Herein we report our current case of an obese girl with typical signs of GBS associated with autonomic dysfunction, cranial nerve deficits and increased intracranial pressure (ICP). We also perform a systematic study presenting and discussing previous case reports of GBS associated with ICHT, papilledema or hydrocephalus, highlighting the differences of the current case compared to previous studies. Although intracranial hypertension is a rare complication of pediatric GBS, clinicians should promptly detect it. Obesity may be a predisposing factor, given the strong association between idiopathic intracranial hypertension (IIH) and weight gain. Neurological evaluation, fundus examination and low threshold for intracranial imaging should be an integral part of medical practice in case of obesity, headache or visual changes in GBS patients.

摘要

吉兰-巴雷综合征(GBS)是急性弛缓性麻痹的常见病因,其特征为四肢迅速进展且通常呈对称性的无力。头痛和颅内高压(ICHT)是GBS非常罕见的并发症。在此,我们报告了一例肥胖女孩的病例,该女孩具有GBS的典型体征,并伴有自主神经功能障碍、颅神经缺损和颅内压(ICP)升高。我们还进行了一项系统研究,展示并讨论了先前关于GBS合并ICHT、视乳头水肿或脑积水的病例报告,突出了本病例与先前研究的不同之处。尽管颅内高压是儿童GBS的罕见并发症,但临床医生应及时发现。鉴于特发性颅内高压(IIH)与体重增加之间存在密切关联,肥胖可能是一个诱发因素。对于GBS患者出现肥胖、头痛或视觉改变的情况,神经学评估、眼底检查以及较低的颅内成像阈值应成为医疗实践中不可或缺的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b8f/7857149/803e990e63d5/fped-08-608695-g0001.jpg

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