Wöhrle J C, Amoiridis G, Heye N, Przuntek H
Department of Neurology, Ruhr-University, St. Josef-Hospital, Bochum, Federal Republic of Germany.
Electromyogr Clin Neurophysiol. 1996 Jan-Feb;36(1):37-41.
We describe a case of acute multifocal motor neuropathy with normal sensory conduction studies in the nerve segments of severe motor conduction block. Antiganglioside antibodies were not detected in serum and the patient recovered spontaneously. The clinical picture and course of time of the illness allowed the diagnosis of a Guillain-Barré syndrome (GBS). The electrophysiological findings closely matched the typical findings of chronic multifocal motor neuropathy with persistent conduction block. From these similarities, we conclude that acute and chronic forms of acquired demyelinating motor neuropathies have to be accepted as variants of acute GBS and chronic inflammatory demyelinating polyneuropathy (CIDP), respectively. We suggest that the conduction block cannot always be attributed to antiganglioside antibodies, as chronic cases without antiganglioside antibodies have also been reported and further elevation of antibody titres has been seen after spontaneous recovery.
我们描述了一例急性多灶性运动神经病,其严重运动传导阻滞神经节段的感觉传导研究结果正常。血清中未检测到抗神经节苷脂抗体,患者自发康复。疾病的临床表现和病程符合吉兰-巴雷综合征(GBS)的诊断。电生理结果与慢性多灶性运动神经病伴持续性传导阻滞的典型表现密切相符。基于这些相似之处,我们得出结论,获得性脱髓鞘性运动神经病的急性和慢性形式应分别被视为急性GBS和慢性炎症性脱髓鞘性多发性神经病(CIDP)的变异型。我们认为传导阻滞不能总是归因于抗神经节苷脂抗体,因为也有报道称存在无抗神经节苷脂抗体的慢性病例,且自发恢复后抗体滴度进一步升高。