Conduction block and axonal degeneration co-occurring in a patient with axonal Guillain-Barr茅 syndrome

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• 作者：Norito Kokubun^a ; ^{kokubun@dokkyomed.ac.jp} ; Nortina Shahrizaila^b ; Koichi Hirata^a ; Nobuhiro Yuki^c
• 关键词：Acute inflammatory demyelinating polyneuropathy ; Acute motor axonal neuropathy ; Acute motor conduction block neuropathy ; Anti-ganglioside antibody ; Conduction block ; Guillain-Barr&eacute ; syndrome
• 刊名：Journal of the Neurological Sciences
• 出版年：2012
• 期刊代码：178_0022510x
• 类别：med
• 出版时间：15 August, 2012
• 卷：319
• 期：1-2
• 页码：164-167
• 文件大小：211 K

摘要

Guillain-Barr茅 syndrome can present as demyelinating or axonal subtypes. Recent studies suggest that the neurophysiology of the axonal subtype not only exhibits axonal degeneration but can also show reversible conduction failure at the early stages. It is less certain if reversible conduction failure is evident in only a minority of patients with a specific subtype associated with better prognosis. We describe a 73-year-old man with Guillain-Barr茅 syndrome and electrodiagnostic features of both reversible conduction block and possible axonal degeneration. Initial features of conduction failure were seen in both median nerves. This was followed by features of axonal degeneration, with corresponding weakness in the left abductor pollicis brevis and lumbricalis muscles, which are innervated by the median nerve, but rapid resolution of conduction block with corresponding rapid clinical recovery in the right. The presence of both features in a single patient provides further evidence that early conduction failure can be followed by either rapid resolution or axonal degeneration in the electrophysiological spectrum of axonal Guillain-Barr茅 syndrome.