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Im, Hwang, Park, Cheong, Lee, and Lee: Guillain-Barre syndrome after generalized tetanus infection
Original Article

Ann Clin Neurophysiol 2017;19(1):64-67.

Published online: 5 January 2017

DOI: https://doi.org/10.14253/acn.2017.19.1.64

Guillain-Barre syndrome after generalized tetanus infection

Seon Jae Im1, Yun Su Hwang1, Hyun Young Park1, Jin Sung Cheong1, Hak Seung Lee1, Jae Hoon Lee

1Department of Neurology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science and Regional Cardiocerebrovascular Center, Iksan, Korea

2Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea

Correspondence to Hyun Young Park Department of Neurology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science and Regional Cardiocerebrovascular Center, 895 Mu-wang-ro, Iksan 54538, Korea Tel: +82-63-859-1410 Fax: +82-63-842-7379 E-mail: hypppark@hanmail.net

Received 14 July 2016

Copyright © 2017 The Korean Society of Clinical Neurophysiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Guillain-Barre syndrome (GBS) is an auto-immune disease of peripheral nerve system. It occurs mainly after preceding infection such as upper respiratory or gastrointestinal infection and other antecedent events as tetanus vaccinations. However, any case of GBS after tetanus infection has not been reported. Recently, when analyzed the clinical aspects of 13 tetanus patients including ours, 2 GBS occurred after tetanus infection. We report the neurological and electrophysiologic findings of two cases of Guillain-Barre Syndrome after generalized tetanus.

Keywords: Autoimmune diseases, Guillain-Barre syndrome, Tetanus

REFERENCES

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Table 1.
Nerve conduction studies of the right upper and lower extremities
Patient 1 (23rd day after onset of tetanus /60th day after onset of tetanus) Patient 2 (8th day after onset of tetanus)
Latency (ms) Amp (µV) NCV (m/s) Latency (ms) Amp (µV) NCV (m/s)
Motor NCS
Median nerve
Wrist 5.7/3.3 0.7/10.2   5.9 5.9  
Elbow   0.7/9.9 37.1/51.3   5.8 49.2
Axilla   0.6/9.6 38.9/58.8   5.6 48.7
F-latency     -/25.6     -
Ulner nerve
Wrist 4.3/2.8 1.7/5.7   6.0 1.0  
Below elbow   1.2/5.6 41.5/65.2   0.7 50.0
Above elbow   0.9/5.5 62.5/62.5   0.4 41.0
Axilla   0.9/5.2 50.0/62.5   0.4 43.5
F-latency     -/25.7     -
Phrenic nerve 11.4/8.0 1.2/2.0        
Peroneal nerve
Ankle -/4.1 -/5.4   8.8 0.2  
Below knee   -/5.6 -/41.7   0.1 26.6
Above knee   -/5.4 - /45.8   0.1 28.6
F-latency     -/40.0     -
Tibial nerve
Ankle -/4.5 -/5.8   8.8 2.5  
Knee   -/5.7 -/42.7   2.2 33.0
F-latency   - -/49.9     60.8
Sensory NCS
Median nerve
Finger-wrist   17.1/26.4 39.3/50.0   3.3 39.6
Wrist-elbow   40.8/31.8 45.9/54.5   19.2 51.0
Elbow-axilla   112.9/98.2 62.5/52.6   84.6 48.9
Ulnar nerve
Finger-wrist   14.9/17.8 51.9/56.3   2.2 39.7
Wrist-elbow   43.4/26.8 50.0/56.8   9.0 58.3
Elbow-axilla   34.3/72.9 52.2/58.8   10.5 47.8
Sural nerve
Calf   13.1/7.8 33.3/36.8   4.1 32.5

Amp, amplitude; NCV, nerve conduction velocity; NCS, nerve conduction study.

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