可逆性脳血管攣縮症候群（Reversible cerebral vasoconstriction syndrome）を合併したGuillain-Barré syndromeの1例

抄録

We present a 64-year-old woman with clinical and neurophysiological evidence of severe Guillain-Barré syndrome (GBS), who developed autonomic dysfunction with severe hypertension. MRI showed symmetrical lesions in the bilateral parieto-occipital lobe which was suggested posterior reversible encephalopathy syndrome (PRES) and MRA demonstrated multifocal cerebral vasoconstriction. After the treatment with intravenous immunoglobulin (IVIg), blood pressure was controlled appropriately and followed MRA revealed resolution of lesions. We diagnosed reversible cerebral vasoconstriction syndrome (RCVS) as a complication of GBS.

RCVS comprise a group of disorders characterized by reversible vasoconstriction of the cerebral arteries. Dysfunction of cerebral autoregulation induced by hypertension is considered as a presumptive mechanism for contributing to RCVS. Autonomic dysfunction is a well-known complication of GBS. Sudden death may be occurred to GBS with autonomic dysfunction. To our knowledge, previously reported cases of RCVS complicating with GBS are rare. RCVS in GBS may be failed to diagnose. Neurologist must be aware of this clinical association so that early treatment can reduce the mortality and morbidity.