Acute paralytic syndrome in three American men. Comparison with Chinese cases
C. E. Jackson, R. J. Barohn and J. R. Mendell
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7883.
OBJECTIVE--To define clinically an unusual acute paralytic syndrome with
features distinctive from those of the Guillain-Barre syndrome and similar
to those described in Chinese children and young adults. DESIGN--Case
series. SETTING--University medical centers. PATIENTS--Three North American
men (mean age, 29 years) who presented with acute symmetric weakness and
muscle cramps after a preceding gastrointestinal tract illness. These
patients had no sensory symptoms, developed no respiratory insufficiency or
facial weakness, and had normal to brisk muscle stretch reflexes.
RESULTS--Results of serial nerve conduction studies were normal except for
low-amplitude motor potentials. Needle electromyography revealed diffuse
denervation potentials. Cerebrospinal fluid showed an elevated protein
level and, in one case, a mild pleocytosis. A sural nerve biopsy specimen
in one patient was normal; muscle biopsy specimens showed denervation
atrophy. CONCLUSION--These cases resemble those described in Chinese
children and young adults and may represent a postviral monophasic process
affecting the anterior horn cell or distal motor nerve terminal. Further
pathologic correlation will be required to identify the exact site of the
lesion. Differentiation is important when considering modes of treatment.
