以周围性面瘫为主要表现的吉兰－巴雷综合征变异型：附2例临床分析

The variant of Guillain-Barré syndrome with peripheral facial paralysis as the main manifestation: A clinical analysis of two cases

摘要:

该文报道了2例以周围性面瘫为主要表现的吉兰－巴雷综合征（GBS）变异型的患者。这2例患者均为以周围性面瘫起病，其中1例为双侧周围性面瘫，伴疼痛；另1例为左侧周围性面瘫合并头晕、思睡、食欲缺乏等。2例患者早期肌电图均未发现异常。1例存在脑脊液―蛋白细胞分离，另1例血清抗GQ1b抗体IgM（+）。诊断为GBS变异型。2例患者均给予静脉滴注人血免疫球蛋白，症状好转后出院。对以周围性面瘫起病的患者，需考虑是单纯的面神经炎还是以周围性面瘫起病的其他疾病，如GBS变异型等，以便正确诊治。

Abstract:

This article reports two patients with the variant of Guillain-Barré syndrome （GBS） with peripheral facial paralysis as the main manifestation. Both patients had peripheral facial paralysis as the initial presentation， among whom one patient had bilateral peripheral facial paralysis with pain， and the other patient had left peripheral facial paralysis with the symptoms such as dizziness， somnolence， and poor appetite. No abnormalities were found on early EMG for the two patients. One patient was found to have albuminocytologic dissociation in cerebrospinal fluid， and the other patient tested positive for serum anti-GQ1b antibody IgM. They were diagnosed with the variant of GBS. Both patients received intravenous drip of human blood immunoglobulin and were discharged after the symptoms were improved. For patients with peripheral facial paralysis as the initial presentation， simple facial neuritis or other diseases with peripheral facial paralysis as the initial presentation should be considered， including the variant of GBS， so as to give correct diagnosis and treatment.