Asymmetric Guillain-Barré syndrome.
Guillain-Barré syndrome (GBS) is a heterogeneous disorder according to clinical, electrophysiological, immunologic and pathologic findings. It has usually been considered as an immune-mediated polyneuropathy clinically characterised by acute symmetric muscle weakness and areflexia. We describe a patient who, after a Campylobacter jejuni infection, developed an acute motor-sensory neuropathy with marked and persistent asymmetry of clinical and electrophysiological findings. He had a high titre of anti-GM1 IgG antibodies and cytoalbuminologic dissociation and was responsive to intravenous immunoglobulins. Investigations and three years of follow-up excluded mimics of GBS. Tendon areflexia has recently been challenged as a mandatory diagnostic criterion in GBS; likewise marked and persistent motor asymmetry does not exclude the diagnosis of GBS.
Logullo
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Clinica Neurologica, Dipartimento di Scienze Neurologiche, Mediche e Chirurgiche, Azienda Ospedali Riuniti, Via Conca 1, I-60020 Ancona, Italy. l.provinciali@univpm.it
Manicone
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Di Bella
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Provinciali
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D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002169:Campylobacter Infections / Q000150:complications* / Q000276:immunology; D005677:G(M1) Ganglioside / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D011930:Reaction Time / Q000502:physiology
D001323:Autoantibodies; D005677:G(M1) Ganglioside