Chapter 34 Guillain-Barré syndrome

Abstract

Publisher Summary This chapter describes the Guillain–Barre syndrome (GBS) that emerged as a distinct clinical entity after Guillain, Barre, and Strohl described two soldiers with reversible motor neuropathy associated with an increased cerebrospinal fluid (CSF) protein and normal CSF cell count. Major advances in understanding GBS have occurred in the past 15 years. The annual incidence of GBS is between 0.4 and 4 per 100,000 throughout the world. There is a slight male preponderance, and the disease becomes more common with advancing age. The chapter recognizes that under the umbrella of GBS are several clinical subtypes with distinctive neurophysiological and pathological, and presumably pathophysiological substrates: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor (AMAN) or motor and sensory (AMSAN) axonal neuropathy, Fisher syndrome (FS), and other rarer variants. Antibodies to peripheral nerve gangliosides are commonly found in some forms of GBS. Anti-GQ1b antibodies are present in almost all patients with FS or with GBS and ophthalmoplegia. Antibodies to peripheral nerve gangliosides are commonly found in some forms of GBS. Anti-GQ1b antibodies are present in almost all patients with FS or with GBS and ophthalmoplegia.