脑梗死合并吉兰-巴雷综合征1例并文献复习

Cerebral infarction with Guillain-Barre syndrome:a case report and literature review

目的:探讨吉兰-巴雷综合征(GBS)与脑梗死之间的潜在关系。方法:报告了1例确诊脑梗死合并GBS的患者,并具体分析两种疾病相继发生的可能机制。结果:1例缺血性脑卒中患者在急性期出现进行性弛缓性四肢瘫痪。结合脑脊液和肌电图结果,患者被诊断为GBS。脑梗死后的GBS可能与一些炎症细胞因子介导致全身炎症反应失衡,外周血T和B淋巴细胞激活等因素相关。结论:脑梗死后的GBS很罕见。脑梗死患者出现四肢无力通常被认为卒中进展或出现电解质紊乱如低钾血症所致。这例患者提醒临床医生,当患有脑梗死的患者诉渐进出现四肢无力或感觉障碍等症状时,还应考虑GBS。

Objective:To investigate the potential relationship between Guillain-Barre syndrome(GBS)and cerebral infarction.Methods:One patient confirmed GBS after acute cerebral infarction was reported,and the possible mechanisms of the two diseases were specifically analyzed.Results:One patient with ischemic stroke,performed progressive flaccid quadriplegia in the acute phase.According to the cere-brospinal fluid assay and electromyographic results,this case was diagnozed as GBS.The imbalance of systemic inflammatory response induced by some inflammatory cytokines and some peripheral blood T and B lymphocytes activation might contributed to the occurrence of GBS after cerebral infarc-tion.Conclusion:GBS after cerebral infarction is rare.Limb weakness is usually considered to be pro-gression of stroke or electrolyte imbalance such as hypokalemia in patients with cerebral infarction.This patient reminds clinicians that GBS should also be considered when patients with cerebral infarc-tion complain of progressive weakness or sensory disturbances.