无糖脂抗体的米勒-费雪综合征、比克斯塔夫脑干脑炎和格林-巴利综合征重叠1例报告及文献复习

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-08-24 DOI:10.1016/j.clineuro.2025.109121

Donghui Shen , Kang Liu , Haifeng Wang

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引用次数: 0

摘要

我们报告一例罕见的56岁女性，尽管血清抗gq1b、GM1、GD1b、GT1a和GT1b IgG抗体阴性，但仍表现出米勒-费氏综合征（MFS）、比氏脑干脑炎（BBE）和格林-巴勒综合征（GBS）的重叠特征。患者在上呼吸道感染后出现序贯神经功能缺损（眼麻痹、共济失调、四肢瘫痪和意识改变）。电生理研究证实急性运动-感觉轴突神经病变，脑脊液分析显示白蛋白细胞分离。双静脉注射免疫球蛋白（IVIG）疗程和甲基强的松龙治疗导致部分恢复，在第76天实现独立行走。该病例强调了重叠抗gq1b抗体综合征的复杂性，并强调了在血清阴性患者中寻找替代诊断生物标志物的必要性。

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Overlapping Miller Fisher Syndrome, Bickerstaff Brainstem Encephalitis, and Guillain-Barré Syndrome without glycolipid antibodies-a case report and literature review

We present a rare case of a 56-year-old female presenting with overlapping features of Miller Fisher syndrome (MFS), Bickerstaff’s brainstem encephalitis (BBE) and Guillain-Barré syndrome (GBS), despite seronegativity for anti-GQ1b, GM1, GD1b, GT1a, and GT1b IgG antibodies. The patient developed sequential neurological deficits (ophthalmoplegia, ataxia, tetraparesis, and altered consciousness) following an upper respiratory infection. Electrophysiological studies confirmed acute motor-sensory axonal neuropathy, while cerebrospinal fluid analysis showed albuminocytological dissociation. Dual intravenous immunoglobulin (IVIG) courses and methylprednisolone therapy led to partial recovery, with independent ambulation achieved by day 76. This case underscores the complexity of overlapping anti-GQ1b antibody syndromes and highlights the need for alternative diagnostic biomarkers in seronegative patients.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.