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Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 54
Author(s) -
D’Avino C,
Cafforio G,
Del Corona A,
Galluzzi F,
Siciliano G
Publication year - 2003
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2003.00054.x
Subject(s) - medicine , guillain barre syndrome , acute motor axonal neuropathy , ataxia , polyradiculoneuropathy , pleocytosis , cranial nerves , antibody , immunology , hyporeflexia , intravenous immunoglobulin therapy , dysgeusia , weakness , pathology , cerebrospinal fluid , surgery , psychiatry , adverse effect
Guillain‐Barré syndrome (GBS) is the prototype of post‐infectious autoimmune neurological disease. Campylobacter Jejuni is the most frequent pathogen antecedent causing a clinical picture characterized by severe, pure motor axonal involvement with IgG antibodies against GM1, GM1b, GD1a or GalNAc‐GD1a gangliosides. As for viral infection, CMV is the most common antecedent associated with demyelinating sensory GBS and anti‐GM2 IgM antibody. Miller‐Fisher syndrome (MFS) is a GBS variant characterized by ataxia, areflexia and ophthalmoplegia associated with anti‐GQ1b IgG antibody. We describe the case of a 41 year‐old man who developed muscle weakness with gait disturbance, paresthesiae and pain at four limbs, taste and voice disturbances 9 days after cutaneous eruption by varicella zoster virus (VZV) infection. At hospital admission the clinical evaluation showed ataxia, deep tendon areflexia, hyposthenia at lower limbs, hypophonia and dysgeusia. Examination of the cerebral spinal fluid (CSF) showed a slight increase in protein concentration with no concomitant pleocytosis; nerve conduction velocity detected the absence of H reflex. At present antibodies titration against gangliosides is under examination. He underwent plasma exchange treatment and is still receiving acyclovir therapy with clinical recovery. Conclusion: this case underlines the clinical variability of acute polyradiculoneuropathy presenting after viral infections other than those classical described with possible overlapping to GB and MF syndrome and confirms the good response to combined gammaglobulin and acyclovir therapy.