We report a case of Guillain-Barré syndrome (GBS) accompanied by optic neuritis and a central white matter lesion subsequent to Epstein-Barr virus (EBV) infection. A 49-year-old man presented with visual disturbance and hemiparesis one week after developing cold-like symptoms. T2- and diffusion-weighted brain MRI showed a high-signal intensity lesion in the left internal capsule. The patient's visual acuity improved during steroid pulse therapy, but his hemiparesis progressed to quadriparesis. Nerve conduction studies showed demyelination predominant in the distal nerve terminals, consistent with GBS. Serological testing suggested EBV reinfection. Our findings indicate that EBV-related central and peripheral demyelination can occur simultaneously and can be successfully treated with a combination of corticosteroids and immunoglobulin.

译文

:我们报告了一例伴有视神经炎和继发爱泼斯坦-巴尔病毒(EBV)感染的中央白质病变的吉兰-巴雷综合征(GBS)。一名49岁的男子在出现感冒状症状后一周出现视觉障碍和偏瘫。 T2和弥散加权脑MRI显示左内囊有高信号强度病变。在类固醇脉冲治疗期间,患者的视力有所改善,但他的偏瘫进展为四肢瘫痪。神经传导研究显示,远端神经末梢主要发生脱髓鞘,与GBS一致。血清学检查提示EBV再感染。我们的研究结果表明,与EBV相关的中枢和外周脱髓鞘可以同时发生,并且可以通过联合使用糖皮质激素和免疫球蛋白成功治疗。

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