中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (9): 769-772.doi: 10.12007/j.issn.0258-4646.2018.09.001

• 论著 •    下一篇

颅神经受累的吉兰-巴雷谱系疾病35例临床分析

盖晴, 冷昶木, 丛树艳   

  1. 中国医科大学附属盛京医院神经内科, 沈阳 110004
  • 收稿日期:2017-12-14 出版日期:2018-09-30 发布日期:2018-09-08
  • 通讯作者: 丛树艳 E-mail:congshuyan@hotmail.com
  • 作者简介:盖晴(1991-),女,医师,硕士研究生.
  • 基金资助:
    国家自然科学基金(81371271);辽宁省"百千万人才工程"资助项目(辽百千万立项[2015]41号)

Clinical Analysis of 35 Cases of Guillain-Barré Syndrome Spectrum Disorders with Cranial Nerve Involvement

GAI Qing, LENG Changmu, CONG Shuyan   

  1. Department of Neurology, Shengjing Hospital, China Medical University, Shenyang 110004, China
  • Received:2017-12-14 Online:2018-09-30 Published:2018-09-08

摘要: 目的 探讨吉兰-巴雷谱系疾病中颅神经受累的临床特点。方法 回顾性分析2016年1月至2017年9月期间我科收治的35例颅神经受累的吉兰-巴雷综合征(GBS)患者的临床资料,进行亚组分类,分析各亚组中颅神经受损特点。结果 35例患者中,经典型GBS13例,Miller-Fisher综合征(MFS)9例,多颅神经型8例,急性眼外肌麻痹型2例,MFS与GBS重叠型2例,Bickerstaff脑干脑炎与GBS重叠型1例。经典型GBS以面神经受累最常见,MFS以展神经受累最常见,多颅神经型GBS以舌咽、迷走神经受累最常见。15例患者行神经节苷酯抗体检测,11例(73%)GQ1b抗体阳性。24例接受3个月的随访,仅1例仍有复视,其余患者颅神经症状均消失。结论 吉兰-巴雷谱系疾病亚组间颅神经受损特点不同,眼外肌麻痹的患者多伴GQ1b抗体阳性。免疫治疗后颅神经症状多为可逆,预后良好。

关键词: 吉兰-巴雷谱系疾病, 颅神经, Miller-Fisher综合征, 抗GQ1b抗体

Abstract: Objective To analyze the clinical features of cranial nerve involvement in Guillain-Barré syndrome(GBS) spectrum disorders. Methods Clinical data of 35 cases of GBS with cranial nerve involvement were retrospectively analyzed. These cases were divided into subgroups, and the characteristics of cranial nerve damage in each subgroup were further examined. Results The patient group included 13 patients with classic GBS, 9 with Miller-Fisher syndrome(MFS), 8 with polyneuritis cranialis, 2 with acute ophthalmoparesis, 2 with MFS-GBS overlap syndrome, and 1 with Bickerstaff brainstem encephalitis-GBS overlap syndrome. The facial nerve is commonly involved in classic GBS; the abducens nerve is often involved in MFS; and the glossopharyngeal and vagus nerves are frequently affected in polyneuritis cranialis. Anti-ganglioside antibodies were tested for in 15 cases, and it was found that anti-ganglioside Q1b(GQ1b) antibodies were present in 11 cases(73%). A total of 24 patients were followed up for 3 months:only 1 patient still had diplopia; however, in other patients, all the symptoms of cranial nerve involvement disappeared. Conclusion The characteristics of cranial nerve damage in different subgroups of GBS spectrum disorders are different. GQ1b antibodies are frequently found in patient with ophthalmoplegia. The prognosis is favorable after immunotherapy.

Key words: Guillain-Barré syndrome spectrum disorders, cranial nerve, Miller-Fisher syndrome, anti-GQlb antibody

中图分类号: 

  • R745.4
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