[Pathophysiological and diagnostic aspects of Guillain-Barré syndrome].

Autor: Carpentier VT; Service de médecine Physique et de Réadaptation, Garches, AP-HP, Université Paris Saclay, Hôpital Raymond Poincaré, Paris, France; U1179 END-ICAP, Inserm, UFR Simone Veil-Santé, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris Saclay, Montigny-le-Bretonneux, France; ISPC Synergies, Paris, France; Groupe de recherche en neuro-orthopédie de Garches (GRENOG), Garches, France., Le Guennec L; Sorbonne Université, Unité de Médecine Intensive Réanimation à orientation neurologique, Département de Neurologie, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, AP-HP.Sorbonne Université, Paris, France; U1016, UMR8104, Institut Cochin, Inserm, CNRS, Université de Paris, Paris, France., Fall SAA; Sorbonne Université, Unité de Médecine Intensive Réanimation à orientation neurologique, Département de Neurologie, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, AP-HP.Sorbonne Université, Paris, France., Viala K; Département de Neurophysiologie Clinique, AP-HP, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France., Demeret S; Sorbonne Université, Unité de Médecine Intensive Réanimation à orientation neurologique, Département de Neurologie, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, AP-HP.Sorbonne Université, Paris, France., Weiss N; Sorbonne Université, Unité de Médecine Intensive Réanimation à orientation neurologique, Département de Neurologie, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, AP-HP.Sorbonne Université, Paris, France; Sorbonne Université, Groupe de Recherche Clinique en RÉanimation et Soins intensifs du Patient en Insuffisance Respiratoire aiguË (GRC-RESPIRE), Paris, France; UMR-S 938 Centre de Recherche de Saint-Antoine, INSERM, Sorbonne Université, Paris, France; Sorbonne Université, Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, Paris, France. Electronic address: nicolas.weiss@aphp.fr.
Jazyk: francouzština
Zdroj: La Revue de medecine interne [Rev Med Interne] 2022 Jul; Vol. 43 (7), pp. 419-428. Date of Electronic Publication: 2022 Jan 06.
DOI: 10.1016/j.revmed.2021.12.005
Abstrakt: Guillain-Barré syndrome (GBS) is the most common cause of acute neuropathy. It usually onset with a rapidly progressive ascending bilateral weakness with sensory disturbances, and patients may require intensive treatment and close monitoring as about 30% have a respiratory muscle weakness and about 10% have autonomic dysfunction. The diagnosis of GBS is based on clinical history and examination. Complementary examinations are performed to rule out a differential diagnosis and to secondarily confirm the diagnosis. GBS is usually preceded by an infectious event in ≈ 2/3 of cases. Infection leads to an immune response directed against carbohydrate antigens located on the infectious agent and the formation of anti-ganglioside antibodies. By molecular mimicry, these antibodies can target structurally similar carbohydrates found on host's nerves. Their binding results in nerve conduction failure or/and demyelination which can lead to axonal loss. Some anti-ganglioside antibodies are associated with particular variants of GBS: the Miller-Fisher syndrome, facial diplegia and paresthesias, the pharyngo-cervico-brachial variant, the paraparetic variant, and the Bickerstaff brainstem encephalitis. Their semiological differences might be explained by a distinct expression of gangliosides among nerves. The aim of this review is to present pathophysiological aspects and the diagnostic approach of GBS and its variants.
(Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: