Guillain-Barré syndrome with overlap between the finger drop variant and acute bulbar palsy: a case report.

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Shota Ito, Satoshi Yokoi, Yuki Fukami, Ayumi Uchibori, Masahisa Katsuno
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引用次数: 0

Abstract

Background: Guillain-Barré syndrome (GBS) is a clinically heterogenous disease and encompasses several distinct clinical variants. Overlap between these variants can pose a diagnostic challenge. We report a case of finger drop variant and acute bulbar palsy overlap as an unusual manifestation of GBS.

Case presentation: An 81-year-old man presented with dysarthria, dysphagia, and upper limb weakness. Neurological examination revealed impaired tongue protrusion, the finger drop sign, and diminished brachioradial and triceps muscle reflexes. Nerve conduction studies showed reduced amplitudes and decreased velocities in the median and ulnar nerves. Cerebrospinal fluid analysis revealed albuminocytological dissociation and an anti-ganglioside antibody study revealed positivity for GM1, asialo-GM1, GT1a, GD1b, and GQ1b. As GBS was suspected, we initiated intravenous immunoglobulin treatment, resulting in gradual improvement within the next 3 weeks.

Conclusion: To the best of our knowledge, this is the first reported case of an overlap between the finger drop variant and acute bulbar palsy in GBS, highlighting the importance of considering GBS when patients present with a combination of atypical symptoms. Anti-ganglioside antibodies can be helpful and add diagnostic value in these complex cases.

格林-巴利综合征并发手指下垂变异型和急性球麻痹:一份病例报告。
背景:格林-巴利综合征(GBS)是一种临床异质性疾病,包括几种不同的临床变异。这些变异型之间的重叠会给诊断带来挑战。我们报告了一例手指下垂变异型与急性球麻痹重叠的 GBS 异常表现病例:一名 81 岁的男性患者出现构音障碍、吞咽困难和上肢无力。神经系统检查显示,他的伸舌能力受损,手指下垂,肱肌和肱三头肌反射减弱。神经传导检查显示,正中神经和尺神经的振幅减小,速度降低。脑脊液分析显示白蛋白细胞学分离,抗神经节苷脂抗体研究显示 GM1、asialo-GM1、GT1a、GD1b 和 GQ1b 阳性。由于怀疑是 GBS,我们开始静脉注射免疫球蛋白治疗,结果在接下来的 3 周内病情逐渐好转:据我们所知,这是首例报道的 GBS 手指下垂变异型与急性球麻痹重叠的病例,这凸显了当患者出现多种不典型症状时考虑 GBS 的重要性。抗神经节苷脂抗体对这些复杂病例有帮助并增加诊断价值。
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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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