Clinical and electrophysiological features of Guillain-Barré syndrome in plateau region
Objective To investigate the clinical and electrophysiological features of Guillain-Barré syndrome(GBS)in plateau region.Methods A retrospective analysis was performed for 16 GBS patients in plateau region who attended Qinghai Provincial People's Hospital for from July 1,2023 to September 30,2024.Results Among the 16 GBS patients,there were 13 patients(81%)with tetraplegia,3(19%)with lower limb paralysis,7(46%)with hypoesthesia,9(56%)with paresthesia,3(19%)with sensory hypersensitivity,16(100%)with weakened or disappeared tendon reflexes,7(37%)with ataxia,2(11%)with oculomotor nerve involvement,2(11%)with bulbar involvement,and 1(6%)with hypoglossal nerve involvement.Among the 16 patients,9(56%)had sympathetic skin response(SSR)abnormalities in the upper extremities,and 10(63%)had SSR abnormalities in the lower extremities.In terms of clinical characteristics,15 patients(94%)had the classical form,and 1 patient(6%)had pharyngeal-cervical-brachial(PCB)form.Electrophysiologically,9 patients(56%)were classified as acute inflammatory demyelinating polyradiculoneuropathy(AIDP),and 7 patients(44%)were classified as acute motor axonal neuropathy/acute motor sensory axonal neuropathy(AMAN/AMSAN).Conclusion The cold and hypoxic environment in plateau region might lead to changes in the human immune system and physiological functions,resulting in critical condition for GBS patients.The clinical manifestations of GBS in plateau region include paralysis of limbs,involvement of cranial nerves and respiratory muscles,and obvious hypoxemia.The electrophysiological impairment can be manifested as demyelination and axonal damage.It is prone to involving small fiber sensory nerves and autonomic nerves in plateau GBS.It may be related to the immune-mediated inflammatory response,mitochondrial energy metabolism disorders of nerve cells,oxidative stress and immune system dysfunction under the high-altitude hypoxic environment.
Plateau regionGuillain-Barré syndromeClinical featuresElectrophysiologic type
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