• Meng-Ying Hsieh, Oi-Wa Chan, Jainn-Jim Lin, Kuang-Lin Lin, Shao-Hsuan Hsia, Huei-Shyong Wang, and Cheng-Hsun Chiu.
• Division of Pediatric Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
• Brain Dev. 2013 Oct 1; 35 (9): 865-9.

BackgroundGuillain-Barré syndrome and myasthenia gravis both lead to muscle weakness but the two combined is uncommon. Detection of these entities can help identify forms of autoimmune neuromuscular diseases that may respond to immunotherapy. This report sought to characterize the clinical features of these two entities when combined.MethodsThis report is of a case of combined Guillain-Barré syndrome and myasthenia gravis. The clinical features were analyzed and correlated to those published in English literature from 1960 to 2012. Ten reports and 12 cases, including the present case, were reviewed.ResultsThere were 12 patients (4 women and 8 men), aged 17 to 84 years, with combined Guillain-Barré syndrome and myasthenia gravis. Four had post-infectious Guillain-Barré syndrome followed by the development of myasthenia gravis concurrently or concomitantly within one month. All cases had symptoms of ptosis and areflexia. The other common presentations were limb weakness, oculobulbar weakness, and respiratory involvement. Functional outcome was mentioned in 10 patients and seven had good outcome (Hughes scale ≤ 2).ConclusionDetection of ptosis with or without ophthalmoplegia, distribution of limb weakness, and reflex can help in recognizing combined Guillain-Barré syndrome and myasthenia gravis. The early recognition of this combination of peripheral nervous and neuro-muscular junction inflammation is important for initial treatment and prognosis.Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

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