Corticospinal tract involvement in a variant of Guillain-Barré syndrome.
To determine the involvement of the corticospinal tract in Guillain-Barré syndrome (GBS), we examined central motor conduction in patients with GBS-like symptoms and hyperreflexia using a magnetic stimulation technique. The subjects were 3 patients who exhibited ascending muscle weakness 2-4 weeks after preceding infections. Deep tendon reflexes were exaggerated in all four limbs of the 3 patients. The results of cerebrospinal fluid examinations revealed protein elevation without pleocytosis. The serum anti-GM(1) antibody titer was elevated in 2 patients. The results of nerve conduction study revealed axonal motor neuropathy and normal F-wave conduction. Central motor conduction time (CMCT) in patients with hyperreflexia was significantly delayed compared to that in patients with GBS and areflexia (p < 0.001), and the delayed CMCTs were significantly improved in the recovery periods (p < 0.001). Although hyperreflexia is a controversial symptom in patients with GBS, these findings indicate that there is functional corticospinal tract involvement in patients with a GBS variant.
Oshima
Y
Y
First Department of Internal Medicine, School of Medicine, University of Tokushima, Kuramoto 3-18-15, Tokushima 770-8503, Japan.
Mitsui
T
T
Endo
I
I
Umaki
Y
Y
Matsumoto
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001369:Axons / Q000502:physiology; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010812:Physical Stimulation; D011712:Pyramidal Tracts / Q000503:physiopathology*; D012021:Reflex, Abnormal / Q000502:physiology