Continuous spectrum of pharyngeal-cervical-brachial variant of Guillain-Barré syndrome.
Arch Neurol
; 64(10): 1519-23, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17923636
ABSTRACT
BACKGROUND:
Pharyngeal-cervical-brachial weakness (PCB) is considered a variant of Guillain-Barré syndrome (GBS). Because of its rarity, there have been no studies of large numbers of patients with PCB.OBJECTIVE:
To clarify the nosological classification of PCB.DESIGN:
Retrospective study.SETTING:
Academic research. Patients Medical records were reviewed of patients who manifested progressive weakness of the pharynx, neck, and upper limbs within 4 weeks of initial onset. MAIN OUTCOMEMEASURES:
Clinical features were analyzed, and antecedent infections and antiganglioside antibodies were investigated.RESULTS:
Diagnoses for 100 patients were "pure PCB" (n = 13), PCB with preserved muscle stretch reflexes (n = 8), GBS overlap (n = 48), Fisher syndrome overlap (n = 26), and Bickerstaff brainstem encephalitis overlap (n = 5). Serological test results showed that 31.0% of antecedent infections in PCB were caused by Campylobacter jejuni. Of the antiganglioside antibodies tested, anti-GT1a IgG antibodies were positive in 51.0% of the patients. Anti-GQ1b IgG antibodies (a serological marker of Fisher syndrome and Bickerstaff brainstem encephalitis) were positive in 39.0%. The IgG antibodies to GM1, GM1b, GD1a, or GalNAc-GD1a (serological markers of an axonal GBS subtype) were positive in 27.0%.CONCLUSION:
This large study identified the clinical profiles of PCB. Clinical overlapping, frequent C jejuni infection, and common antiganglioside antibodies present in PCB, GBS, Fisher syndrome, and Bickerstaff brainstem encephalitis provide conclusive evidence that PCB and these conditions form a continuous spectrum.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Músculos Faríngeos
/
Debilidade Muscular
/
Síndrome de Guillain-Barré
/
Extremidade Superior
/
Músculos do Pescoço
Idioma:
En
Ano de publicação:
2007
Tipo de documento:
Article