Clinical significance of serum and CSF findings in the Guillain-Barré syndrome and related disorders.

Abstract

Clinical data and the serum and cerebrospinal fluid (CSF) findings of 71 patients with Guillain-Barré syndrome (GBS), 7 with Fisher syndrome and 24 with chronic inflammatory polyradiculoneuropathy (CIP), were analysed. Isoelectric focusing of serum and CSF together with different formulae and diagrams were applied to study blood-CSF barrier (BCB) function and possible intrathecal IgG synthesis. The CSF total protein concentration and its IgG percentage depended mainly on the degree of BCB damage, which correlated with the clinical course. Our investigations suggest that oligoclonal IgG of CSF from these patients comes essentially from serum. In the group of GBS patients, oligoclonal IgG was transitory and correlated significantly with the development of BCB damage, cranial neuritis and severity of the disease. CIP patients showed a stable IgG pattern, which varied slightly after immunosuppressive therapy.