Flaccid quadriparesis with raised creatine kinase in Guillain-Barre syndrome: a case report with review of literature

Bandari Mahesh; Abhishek Pathak; Rameshwar Nath Chaurasia; Anand Kumar; Varun Kumar Singh

doi:10.18700/jnc.210011

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자료유형: 학술저널

저자정보: Bandari Mahesh (Banaras Hindu University) Abhishek Pathak (Banaras Hindu University) Rameshwar Nath Chaurasia (Banaras Hindu University) Anand Kumar (Banaras Hindu University) Varun Kumar Singh (Banaras Hindu University)

저널정보: 대한신경집중치료학회 Journal of Neurocritical Care Journal of Neurocritical Care Vol.14 No.2

발행연도: 2021.12

수록면: 117 - 120 (4page)

DOI: 10.18700/jnc.210011

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Background: Guillain-Barre syndrome (GBS) is an immune-mediated inflammatory polyneuropathy characterized by acute flaccid paralysis. Elevated creatine kinase (CK) levels in GBS have been reported to be transient, and levels vary from mild to severe. Herein, we report a case of GBS with elevated CK mimicking acute myositis.Case Report: A 48-year-old man presented with pure motor flaccid quadriparesis. Power was 2/5 with hypotonia and areflexia in all four limbs. A nerve conduction study revealed reduced compound muscle action potential in all recorded motor nerves. Serum CK was 2,334 U/L. The patient’s symptoms progressed despite intravenous methylprednisolone administration. Cerebrospinal fluid (day 8) revealed albuminocytological dissociation, and electromyography (day 21) revealed spontaneous activity with neurogenic motor unit action potential suggestive of acute motor axonal neuropathy variant of GBS.Conclusion: In a patient with elevated CK and ascending paralysis, differential diagnosis of GBS should be considered and cerebrospinal fluid study and electromyography should aid in confirming the diagnosis.

#Guillain-Barre syndrome #Flaccid quadriparesis #Creatine Kinase #Intravenous immunoglobulin

참고문헌 (10)

참고문헌 신청

Yuki N / 2012 / Guillain-Barré syndrome / N Engl J Med 366:2294~2304

Silvestri NJ / 2013 / Asymptomatic/pauci-symptomatic creatine kinase elevations(hyperckemia) / Muscle Nerve 47:805~815

Chahin N / 2009 / Serum creatine kinase levels in spinobulbar muscular atrophy and amyotrophic lateral sclerosis / Muscle Nerve 40:126~129

Ropper AH / 1984 / Pain in Guillain-Barré syndrome / Arch Neurol 41:511~514

Scott AJ / 1991 / Acute rhabdomyolysis associated with atypical Guillain-Barrésyndrome / Postgrad Med J 67:73~74

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