一种复发性和非典型形式的吉兰-巴雷综合征：一例病例报告
A Recurrent and Atypical Form of Guillain-Barré Syndrome: A Case Report.
摘要(中文译文)
吉兰-巴雷综合征（GBS）是一种急性炎症性多神经根神经病，以快速进展的感觉运动障碍为特征，典型表现为上升性和单相性。复发型和下降型罕见，可能使诊断复杂化。我们报告一例表现为下降性瘫痪的儿童非典型复发性GBS病例。我们描述一名九岁女孩，有典型GBS病史，因急性下降性弛缓性瘫痪入住儿科重症监护病房。临床病程迅速进展为四肢瘫痪，伴延髓和呼吸受累。神经肌电图显示急性脱髓鞘性运动多神经病，脑脊液分析显示蛋白细胞分离，脊柱MRI显示马尾神经根强化，抗神经节苷脂抗体阳性。患者需要机械通气和多个疗程的静脉注射免疫球蛋白（IVIG），随后神经功能显著恢复，三个月时完全缓解。复发性GBS罕见。下降性瘫痪在该病中为非典型表现，可能延误诊断。在此类病例中，反复临床评估和支持性辅助检查至关重要。对反应不佳的病例重复IVIG疗程的获益仍不确定，证据有限。本病例强调了在急性弛缓性瘫痪中考虑GBS的重要性，即使表现非典型和复发，并强调了辅助检查在此类情况下的诊断价值。
Abstract
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy characterized by rapidly progressive sensorimotor impairment that is classically ascending and monophasic. Recurrent and descending forms are rare and may complicate diagnosis. We report an atypical recurrent case of GBS in a child presenting with descending paralysis. We describe a nine-year-old girl with a history of typical GBS who was admitted to the pediatric ICU for acute descending flaccid paralysis. The clinical course rapidly progressed to tetraplegia with bulbar and respiratory involvement. Electroneuromyography showed acute demyelinating motor polyneuropathy, CSF analysis revealed albuminocytologic dissociation, spinal MRI demonstrated cauda equina nerve root enhancement, and anti-ganglioside antibodies were positive. The patient required mechanical ventilation and multiple courses of IVIG, with subsequent significant neurological recovery and complete remission at three months. Recurrent GBS is rare. Descending paralysis is atypical in this disease and may delay diagnosis. In such cases, repeated clinical evaluation and supportive paraclinical investigations are essential. The benefit of repeated courses of IVIG in poorly responsive cases remains uncertain and is supported by limited evidence. This case highlights the importance of considering GBS in acute flaccid paralysis, even in atypical and recurrent presentations, and underscores the diagnostic value of paraclinical investigations in such contexts.
如何引用
AMA
Larbi Ed Dafali, Shaimae Semlali, Hind Lachraf, Saad Elharrak, Salma Ech Cherif El Kettani. A Recurrent and Atypical Form of Guillain-Barré Syndrome: A Case Report.. Cureus. 2026; doi:10.7759/cureus.113362.
APA
Larbi Ed Dafali, Shaimae Semlali, Hind Lachraf, Saad Elharrak, Salma Ech Cherif El Kettani (2026). A Recurrent and Atypical Form of Guillain-Barré Syndrome: A Case Report.. Cureus. https://doi.org/10.7759/cureus.113362
GB/T 7714
Larbi Ed Dafali, Shaimae Semlali, Hind Lachraf, Saad Elharrak, Salma Ech Cherif El Kettani. A Recurrent and Atypical Form of Guillain-Barré Syndrome: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.113362.
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