Literature Review on Adverse Events Following Immunization for Influenza Virus Vaccine / 中国疫苗和免疫

To evaluate security of influenza virus vaccines by analysis of adverse reaction to influenza virus vaccine,especially the relationship between Guillain Barr? syndrome and influenza vaccines.

A Case With Suspected Tick Paralysis

Tick paralysis is caused by a neurotoxin secreted by female tick. Characteristic initial manifestation is bilateral flaccid ascending paralysis similar to Guillain-Barr? syndrome. The predominant electrophysiological abnormality is a reduction in complex muscle action potentials. Here, we present a 62-year-old man who initially experienced a sudden biting pain on his scalp. Subsequently he developed bilateral lower extremity paralysis that ascended symmetrically involving the upper extremities. Within 2 weeks, the patient showed a full recovery without treatment.

A Case of Acute Hepatitis A Complicated by Guillain-Barre Syndrome / 대한간학회지

We report here a case of acute hepatitis A, which was complicated by Guillain-Barr? syndrome (GBS). A 32-year old male admitted to our hospital with the symptoms of acute hepatitis and was diagnosed to have acute hepatitis A with positive IgM anti hepatitis A virus antibody. On 9th day after the onset of jaundice, acute progressive, ascending, symmetric motor paralysis were developed and eventually respiratory failure ensued. Cerebrospinal fluid analysis showed albumino-cytologic dissociation and nerve conduction velocity test suggested a polyradiculopathy. He was diagnosed to have GBS and treated with intravenous immunoglobulin and required a ventilatory support. After 90 hospital days, he recovered in ambulatory condition with the aid of crutches. The clinical course, prognosis and the outcome of neuropathic symptoms of GBS following acute hepatitis A were relatively poor in our case.

The analysis of misdiagnosis and mismanagement of 145 patients with Guillain-Barr? syndrome in the emergency department / 中华急诊医学杂志

Objective To study the clinical characteristics of Guillain-Barr? syndrome(GBS) and the misdiagnosis and mismanagement in emergency department.Methods According to the diagnosis criteria of Chinese Journal of Neurology and Psychology,145 GBS in-hospital patients in our hospital from January 1,1994 to December 312004 were studied to find characteristics of GBS and auxiliary examinations.The reasons for GBS misdiagnosis and mismanagement were analysis.Results Most of the patients were young,the ratio of male to female was 2.5 to 1.Among them,mild-type was 34.5%,medium-type was 25.5%,severe-type was 13.9%,very severe-type was 7.6%,relapse-type was 4.1%,chronic-type was 12.4% and variation-type was 2.1%.The initial symptoms were multiplie.Bilateral limbs weakness and/or numbess were the most common symptom,and non-specificity asymmetrical weakness and/or numbess,headache,ophthalmalgia,distortion of angle of mouth or weak mastication were uncommon symptoms.Twenty-three patients(15.9%)were misdiagnosed in emergency department.71.3% patients developed albuminocytolgoic dissociation in cerebrospinal fluid.The content of protein in cerebrospinal fluid was correlated to the course of disease and uncorrelated to the patitent's condition.Conclusion GBS was a common cause of clinical acute flaccid paralysis,the mild-type has good prognosis and the mortality of very serere-type is high.GBS should be paid attention to in emergency department.

Sequencing of WLAX gene in Guillain-Barr? Syndrome-associated Campylobacter jejuni strains / 基础医学与临床

Objective To investigate the characteristic of sequences of WLAX gene in Campylobacter jejuni(C.jejuni)strains.Methods WLAX gene and the neighbouring sequences were amplified by polymerase chain reaction(PCR).The PCR products were cloned into the vectors of plasmid.The positive recombinants were sequenced and the results were processed by software DNAstar.Results The variation frequency of WLAX sequences in GBS-related C.jejuni was higher than that in non-GBSrelated C.jejuni.The nucleotide sequences of WLAX gene in all the strains in the present study differed from that in genome sequencing strain NCTC11168.The phylogenic tree reflected the regional feature of C.jejuni.Conclusions The probability of sequence variation of WLAX in GBS-related C.jejuni is significantly higher than non-GBS-associated C.jejuni strains,the relation between the variation and GBS-pathogenesis remains to be further confirmed.

A Case of Mycoplasma pneumoniae Pneumonia Complicated with Guillain-Barre Syndrome and Encephalitis / 소아과

The most common pathogen of respiratory tract infection among school-age children and adolescents is Mycoplasma pneumoniae, which causes clinical manifestations of pneumonia, acute asthmatic attack, pharygitis, and tonsilitis. It can also cause extrapulmonary infections that involves skin, the nervous system, the digestive system, the cardiovascular system, and the hematopoietic system. It is reported that the central nervous system symptoms may occur in 0.1% to 7% of patients hospitalized with Mycoplasma pneumoniae infection. Direct invasion, toxin, immune-mediated, and vascular phenomenon have been proposed for the etiology of the neurological manifestations. We have experienced a six-year-old male patient with Mycoplasma pneumoniae pneumonia who had complained of both leg pains and immobility two weeks after the onset of pneumonia, which was confirmed as peripheral neuropathy of Guillain-Barr syndrome. Three weeks after the disease-onset, altered consciousness and seizure attacks developed and intravenous immunoglobulins infused under the impression of encephalitis induced by Mycoplasma pneumoniae infection. He showed complete recovery of running and mentality five months after the disease-onset. We herein report a case of Mycoplasma pneumoniae pneumonia complicated with Guillain-Barr Syndrome and encephalitis about 2 or 3 weeks after the disease onset with a review of literatures.

The value of A-waves in diagnosis of Guillain-Barr? Syndrome / 中华物理医学与康复杂志

0.05).However,A-waves were recorded in 7 patients who were with normal F-waves.Conclusion The occur- rence of A-waves,especially of multiple type,in the ulnar and median nerves might be helpful for the early diagnosis of Guillain-Barr?Syndrome.

The investigation of S-100 proteing level of cerebrospinal fluid and blood serum in patients with Guillain-Barr? syndrome / 中华神经科杂志

Objective To investigate the concentration of S-100 protein presenting in cerebrospinal fluid (CSF) and blood serum in patients with Guillain-Barr? syndrome (GBS), and discuss the value of assessment in measuring S-100 protein level to Schwann′s cell insult. Methods S-100 beta protein was measured dynamically by ELISA in CSF and blood serum from 50 patients with GBS and 22 referencesThe patients were divided into two categories by disease severity: the severe group and the mild groupMeanwhile, CSF cytology was also detected. Results (1) The level of CSF S-100 beta protein in both severe and mild groups were higher than that of the control group (P0.05)(2) The percentage of CSF monocyte in severe group was higher than that of the mild and the control groups(P0.05)(3) There was a dynamic change of CSF S-100 beta protein level in GBS patients correlated with the percentage of CSF monocyte and the severity of disease. Conclusions CSF and blood serum S-100 beta protein level in patients with GBS may be related to the severity of the disease.

Epidemiological survey of Guillain-Barr? syndrome in Harbin from 1997 to 1999 / 中华神经科杂志

Objective To describe the epidemiological characters of Guillain Barr? syndrome (GBS) patients in Harbin Methods During Oct 1st, 1997 to Sep 30th, 1999, a surveillance system of GBS among 5 410 910 residents in Harbin and five counties was established, and general conditions of GBS patients were recorded Results The incidence rate of GBS in Harbin was 0 67/100 000 The highest age specific incidence rate was observed in 0～9 years Patients suffered GBS mainly in Autumn and Summer 74 6% of the patients had antecedent disease, especially respiratory tract infection The average period from onset to climax was 8 8 days The death rate was 5 6% Conclusion The incidence rate of GBS in Harbin should be similar to the average level in the world Epidemiology of GBS in Harbin should have its own characteristics

Predictors at nadir of severity on patients with Guillain-Barr? syndrome / 中华神经科杂志

Objective To explore the factors relating to the severity of Guillain-Barr? syndrome (GBS) (i.e. of being the mild form or in need of mechanical ventilation), and to find the predictors in early clinical presentations and laboratory investigations as to guiding the early management of GBS. Methods All 123 cases of patients with GBS admitted to Xuanwu Hospital from 1996-2002 were collected, and divided into two groups based on the international criteria for different severity of GBS. Mildly affected patients (i.e. able to walk unaided during the whole course or the Medical Research Council [MRC] muscle power grading scale≥4 in both lower limbs at nadir) and ventilated patients (i.e. in need of mechanical ventilation) were divided in this study. Characteristics of each group in early clinical presentations and laboratory investigations were analyzed in univariate conditional Logistic model in order to find out the predictors. Results In all 123 patients studied, 32 were having mild GBS; 29 severe GBS (i.e. in need of mechanical ventilation during the course). Men (P=0.047) and patients without bulbar dysfunction (P=0.002) were more likely to become mild GBS. The possibility of being mild form was 3.33∶1 between man and woman, 1∶20.17 between those with and without bulbar dysfunction. Patients with bulbar dysfunction (P

A Case of Guillain-Barr Syndrome Coinciding with Bronchial Asthma associated with Mycoplasma Pneumonia

Mycoplasma pneumoniae is the most common etiologic agent of pneumonia in school-aged children and young adults. It involves not only the respiratory system but includes extrapulmonary complications such as exanthem, hemolysis, arthritis, hepatic dysfuction, cardiac disease, and central nervous system disease. The pathogenesis of extrapulmonary involvements may be an autoimmune phenomena. Recent studies suggest that bronchial asthma can be initiated by Mycoplasma pneumoniae infection. We experienced a five-year-old girl suffering simultaneously from Guillain-Barr syndrome and initial bronchial asthmatic attack after mycoplasma pneumonia. She was admitted with lower-leg pain and weakness for three days. Ten days before admission, she was coughing and showed on a chest X-ray, pneumonic infitrations of both subhilar peribronchial areas. The titers of anti-mycoplasma antibody and cold hemagglutinin were 1:80 and 1:32, respectively. With a progression of paralysis to the upper extremities, she showed dyspnea, dysphagia and right facial palsy on the second hospital day. We performed a tracheostomy and started artificial ventilation. Unexpectedly, she showed continuous dyspnea, poor lung aeration and revealed severe hypoxemia in serial arterial gas analysis. Intravenous theophylline, high-dose corticosteroid and intravenous immunoglobulin therapy resulted in a progressive improvement of lung condition. She recovered completely from neurologic and pulmonic complications after five weeks.

A Case of Guillain-Barr Syndrome Complicated by Persistent Hypertension / 대한소아신경학회지

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.

A Case of Acute Motor Axonal Type Guillain-Barr Syndrome with Anti-GM1 Antibody and Anti-GD1 Antibody / 대한소아신경학회지

Acute motor axonal Guillain-Barr syndrome is a paralytic disorder of abrupt onset, characterized electrophysiologically by near-normal terminal latencies, preserved nerve conduction velocity with low CAMP amplitude without a conduction block, and early appearing nerve inexcitability and by sparing sensory fibers. Most cases have antecedental infection with Campylobacter jejuni and have antibodies directed toward GM1 ganglioside-like epitopes. We have experienced a case of primary axonal type of Guillain-Barr syndrome in a 14-year-old female patient, who has symptoms of difficulty in swallowing and progressive flaccid paralysis associated with anti-GM1 antibody and anti-GD1 antibody.

Acute Sensory Neuronopathy; Identified with Electrodiagnosis and Magnetic Resonance Imaging

We report a 13 year-old female child with a idiopathic acute sensory neuronopathy mimicking a sensory form of Guillain-Barr syndrome, identified with electrodiagnosis and spine MRI. Motor conduction results were normal, but sensory nerve action potentials were not evoked in all four extremities. On MRI of the whole spine, the diffuse gadolinium-enhancement of dorsal roots in the spinal canal was detected without evidence of intramedullary lesion. The clinical symptoms and electrodiagnostic abnormalities had persisted for more than 18 months follow-up.

Relationship between Clinical Neuro-Electrophysiology and Prognosis in Children with Guillain-Barr? Syndrome / 实用儿科临床杂志

ObjectiveTo explore the relationship between the changes of neuro-electrophysiology and prognosis in children with Guillain-Barr? syndrome(GBS).MethodsThirty-eight children with GBS were divided into group A(rapid recovery,n=16) and group B(slow recovery,n=22) according to the time required for podosoma motor function recovery,at the same time,they were divided into the better prognosis group(n=22) and the worse prognosis group(n=16),for analyzing the difference between group A and B in terms of age,preceding infections,maximal Hughes grades and neuro-electrophysiology including motor conduction velocity(MCV),distal complex muscle action potential(dCMAP) and F wave,and investigating the related factors with the prognosis of GBS.Results1.MCV of tibial nerve was(40.2?2.53) m/s and(33.4?2.46) m/s in group A and group B,respectively;MCV of peroneal nerve was(45.2?3.23) m/s and(38.3?2.16) m/s in group A and group B,respectively,and the difference between group A and group B was significant(Pa0.05);abnormal rate of F wave(68.42%) was higher than abnormal rate of MCV(42.11%) and dCMAP(42.11%)(Pa