Okubo So, Maeda Meiko, Katsuse Kazuto, Ishiura Hiroyuki, Shirota Yuichiro, Hamada Masashi, Satake Wataru, Toda Tatsushi
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan.
Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Intern Med. 2025 Jun 15;64(12):1900-1905. doi: 10.2169/internalmedicine.4667-24. Epub 2024 Nov 28.
Anti-GM1 antibodies are associated with Guillain-Barré syndrome (GBS), primarily peripheral neuropathy. However, there are cases of anti-GM1 IgG antibody-positive GBS with upper motor neuron (UMN) signs. We herein report a case of gastrointestinal infection followed by subacute gait disturbance with predominant signs of UMN on a neurological examination. The serum and cerebrospinal fluid tests were positive for anti-GM1 and anti-asialo-GM1 IgG antibodies. An electrophysiological evaluation revealed normal nerve conduction and prolonged central motor conduction times. No magnetic resonance imaging abnormalities were observed. The symptoms improved with treatment, which was accompanied by decreased antibody titers. This case highlights the fact that anti-GM1 IgG-associated disorders may present with predominant UMN involvement.
抗GM1抗体与吉兰-巴雷综合征(GBS)相关,主要是周围神经病。然而,存在抗GM1 IgG抗体阳性的GBS病例伴有上运动神经元(UMN)体征。我们在此报告一例胃肠道感染后出现亚急性步态障碍,神经系统检查主要表现为UMN体征的病例。血清和脑脊液检测抗GM1和抗唾液酸GM1 IgG抗体呈阳性。电生理评估显示神经传导正常,中枢运动传导时间延长。未观察到磁共振成像异常。经治疗症状改善,同时抗体滴度下降。该病例突出了抗GM1 IgG相关疾病可能以UMN受累为主的这一事实。