Guillain-Barre Syndrome Publications (7795)


Guillain-Barre Syndrome Publications

BMC Res Notes
BMC Res Notes 2015;8(1):729. Epub 2015 Nov 27.
Department of Medicine, University of Peradeniya, Kandy, Sri Lanka.
BMJ Case Rep
BMJ Case Rep 2015 25;2015. Epub 2015 Nov 25.
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, New York, USA.
Neurotherapeutics 2015 Nov 24. Epub 2015 Nov 24.
National Referral Center for Rare Neuromuscular Diseases, Institut Hospitalo-Universitaire de Neurosciences, University Hospital Pitié-Salpêtrière and University Pierre et Marie Curie (Paris VI), Paris, France.

Immunotherapy has been investigated in a small subset of peripheral neuropathies, including an acute one, Guillain-Barré syndrome, and 3 chronic forms: chronic inflammatory demyelinating polyradiculoneuropathy, multifocal motor neuropathy, and neuropathy associated with IgM anti-myelin-associated glycoprotein. Several experimental studies and clinical data are strongly suggestive of an immune-mediated pathogenesis. Either cell-mediated mechanisms or antibody responses to Schwann cell, compact myelin, or nodal antigens are considered to act together in an aberrant immune response to cause damage to peripheral nerves. Read More

Immunomodulatory treatments used in these neuropathies aim to act at various steps of this pathogenic process. However, there are many phenotypic variants and, consequently, there is a significant difference in the response to immunotherapy between these neuropathies, as well as a need to improve our knowledge and long-term management of chronic forms.

Anc Sci Life
Anc Sci Life 2015 Jul-Sep;35(1):52-57
Department of Kayachikitsa, Government Ayurved College, Nagpur, Maharashtra, India.

Guillain-Barre syndrome is an acute, frequently severe and fulminant polyradiculopathy that is autoimmune in nature. Guillain Barre syndrome is a rare disorder that causes immune systems to attack peripheral nervous system (PNS). A 46 year old male patient, presenting with sudden onset, complete paralysis of all four limbs (quadriplegia), unable to walk, stand, sit, difficulty in deglutition (dysphagia) and dysarthia, was having foley's catheter and Ryle's Tube brought by relative to Out Door Patient Department (OPD) of Government Ayurvedic Hospital, Nagpur; He was provisionally diagnosed as subacute sensory motor paraplegia. Read More

Previously patient admitted and treated in Government Medical College (GMC) Nagpur but did not show any sign of improvement so patient was admitted and treated with Ayurvedic treatment for about 50 days. As per Ayurvedic classics, this condition can be correlated with sarvāṅ gagatavātavyādhi (~vāta disorder affecting all parts of the body), which is apatarpaṇa in nature (~diseases with deprived nourishment of body tissue) preceded by jvara (~(H/O fever before onset of GBS). Hence, the principle of treatment is santarpaṇa cikitsā (~nourishing treatment). Santarpaṇa (~nourishing treatment) includes bahyopakramas (~nourishing external treatment modalities), such as abhyaṅga (~oleation therapy) and ṣaṣṭikaśālipiṇḍasveda (~sudation using of hot and processed ṣaṣṭika rice), karmabasti (~medicated enema) śirodhārā (gentle pouring of medicated liquid over forehead) and jvaraghna cikitsā (~treatment of fever) using various Ayurvedic herbomineral compounds. Remarkable results were observed in the form of improvement in the muscle power from zero to five of all four limbs with improvement in speech. There was no difficulty post treatment in deglutition, sitting, standing and walking; and now patient has near to normal movements.

J Clin Neuromuscul Dis
J Clin Neuromuscul Dis 2015 Dec;17(2):88-93
Departments of *Neurology; †Radiology; and ‡Pathology, University of Texas Health Science Center at Houston, Houston, TX.

POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) is a disorder that mainly affects adults. We report a pediatric patient, initially considered to have Guillain-Barré syndrome, who continued to have progression of neuropathic disease leading to the diagnosis of chronic inflammatory demyelinating polyneuropathy. Diagnosis of POEMS was established by an abnormal bone marrow biopsy, prompted by laboratory and imaging findings, which became abnormal later in the course of the disease. Read More

POEMS syndrome is extremely rare in children, and neuropathic features in this age group have not been previously described. This case illustrates that "Guillain-Barré syndrome-like" initial presentation for POEMS, which has not been previously reported. It also emphasizes that in children with progressive acquired neuropathies that are treatment unresponsive, POEMS syndrome should be considered.

J Clin Neuromuscul Dis
J Clin Neuromuscul Dis 2015 Dec;17(2):47-51
*Department of Neurology, Yale University School of Medicine, New Haven, CT; †Department of Neurology, Medical College of Wisconsin, Milwaukee, WI; and ‡Department of Neurology, Hospital for Special Surgery, New York, NY.

The cerebrospinal fluid (CSF) protein level is known to be elevated in patients with Guillain-Barré syndrome (GBS). This report correlates the degree of CSF protein elevation with the number of electrophysiologic abnormalities on nerve conduction study (NCS).
We reviewed 38 patients admitted to our institution with a diagnosis of GBS and had both a measured CSF protein level and a NCS within 24 hours of each other. Read More

CSF protein level correlates with the number of NCS demyelination criteria, as described by Cornblath, in patients with GBS.
This retrospective study is the first to demonstrate a relationship between the CSF protein level and the electrophysiologic abnormalities that accompany GBS.

Crit Care
Crit Care 2015 17;19:407. Epub 2015 Nov 17.
Department of Nephrology, the Second Hospital of Jilin University, Changchun, Jilin Province, China.
Brain Nerve
Brain Nerve 2015 Nov;67(11):1421-8
Department of Neurology, Graduate School of Medicine, Chiba University.

Intravenous immunoglobulin (IVIg) and plasma exchange (PE) are of proven efficacy and are considered the standard therapy for Guillain Barré syndrome (GBS). However, some patients require artificial ventilation during the acute phase and experience long-lasting neurological deficits or symptoms. Currently, there is no established therapeutic intervention for GBS other than IVIg and PE, even though a number of compounds have been investigated. Read More

Clinical trials to investigate the efficacy and safety of a second IVIg or eculizumab are ongoing. Increased understanding of the pathophysiology of GBS is expected to contribute to the development of a novel therapeutic approach.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1411-9
Division of Neurology, Department of Internal Medicine, National Defense Medical College.

Clinical outcome of Guillain-Barré syndrome (GBS) is poorer than may be expected, despite recent applications of plasmapheresis and IVIg. Among prognostic factors of GBS, clinical factors are more useful compared to electrophysiological or biological factors. To improve the outcome of GBS patients with poor prognoses, a worldwide prospective survey (IGOS, International GBS Outcome Study) and a Japanese prospective GBS outcome study (JGOS) have been conducted. Read More

These surveys make it possible to define biomarkers for disease activity and recovery, and to develop prognostic models to precisely predict the clinical course and outcome in individual patients in the early stage of the disease.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1397-410
Department of Neurology, Saitama Medical Center.

The treatment of Guillain-Barre syndromé (GBS) was mainly symptomatic until the 1950s, followed by corticosteroid treatment in the 1950s through 1960s. Plasma exchange (PE) was then performed during 1970s through the 1980s, after which intravenous immunoglobulin (IVIg) was performed in 1990s through the 2000s. The effectiveness of IVIg and PE has been established by randomized controlled trial(RCT). Read More

Recently, new treatments using biological products have been explored. In this paper, we summarize the development of the treatment of GBS.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1388-96
Department of Neurology, Teikyo University School of Medicine.
Brain Nerve
Brain Nerve 2015 Nov;67(11):1371-6
Department of Neurology, Graduate School of Medicine, Chiba University.

Fisher syndrome has been regarded as a peculiar inflammatory neuropathy with ophthalmoplegia, ataxia, and areflexia, whereas Bickerstaff brainstem encephalitis has been considered a pure central nervous system disease characterized by ophthalmoplegia, ataxia, and consciousness disturbance. Both disorders share common features including preceding infection, albumin-cytological dissociation, and association with Guillain-Barré syndrome. The discovery of anti-GQ1b IgG antibodies further supports the view that the two disorders represent a single disease spectrum. Read More

The lesions in Fisher syndrome and Bickerstaff brainstem encephalitis are presumably determined by the expression of ganglioside GQ1b in the human peripheral and central nervous systems. Bickerstaff brainstem encephalitis is likely to represent a variant of Fisher syndrome with central nervous system involvement.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1359-69
Department of Neurology, Graduate School of Medicine, Chiba University.

Guillain-Barré syndrome is classified into demyelinating type, acute inflammatory demyelinating polyneuropathy (AIDP) and axonal form, acute axonal motor neuropathy (AMAN). It has been clearly established that the target molecule for the former is a ganglioside. In contrast, despite years of effort, the target molecule for the latter has not been identified. Read More

Recently, molecules around the nodes of Ranvier have entered the spotlight, and "moesin" was reported to be a target molecule for cytomegalovirus associated-AIDP.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1347-57
Department of Neurology, School of Medicine, Kyorin University.

Serum antibodies against glycolipids, mainly gangliosides, are detected in about 60% of patients with Guillain-Barré syndrome (GBS) and its variants. Anti-glycolipid antibodies play a crucial role in the pathogenic mechanisms of GBS. The antibody titer is the highest in the acute phase and decreases gradually. Read More

Molecular mimicries occur between the glycolipids and surface molecules on the infectious agents. Clinical subtypes of GBS are related to the antigenic specificities of the antibodies. The distribution of gangliosides in peripheral nervous tissues could explain the different clinical manifestations. The anti-GQ1b antibody is detected in 80-90% of patients with Fisher syndrome characterized by ophthalmoplegia. GQ1b is localized in the paranodes of the human cranial nerves innervating the extraocular muscles. This is consistent with the clinical association between the anti-GQ1b antibody and ophthalmoplegia. The anti-GM1 antibody is associated with acute motor axonal neuropathy, whereas the anti-GD1b antibody is detected in acute sensory ataxic neuropathy. GBS animal models sensitized by gangliosides, such as GM1 or GD1b, develop monophasic peripheral neuropathies. In the animal models, disruption of molecule clusters and deposition of complement products were observed in the nodal and paranodal regions. Clinical and experimental data suggest complement-mediated pathogenic mechanisms triggered by anti-glycolipid antibodies in GBS.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1329-39
Department of Neurology and Clinical Neuroscience, Yamaguchi University, Graduate School of Medicine.

Guillain-Barré syndrome is composed of two distinct clinicopathological entities: acute inflammatory demyelinating polyradiculoneuropathy (AIDP), and acute motor or motor and sensory axonal neuropathy (AMAN and AMSAN). AIDP is characterized by the patchily distributed demyelinative foci throughout the peripheral nervous system (PNS), whereas in AMAN/AMSAN primary axonal degeneration is observed in the PNS, particularly accentuated at the spinal nerve roots. The aim of this article is to provide an overview of previous findings regarding GBS pathology and thus, to elucidate the pathomechanisms of this life-threatening disorder. Read More

The most critical cause for AIDP may be the autoimmune attack on the Schwann cell membrane wrapping the myelinated nerve fibers, and that in AMAN/AMSAN may be an antibody-mediated attack on the axolemma at the nodes of Ranvier.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1321-8
Department of Neurology, Dokkyo Medical University.

The electrodiagnostic features for the demyelinating and axonal subtypes of Guillain-Barré syndrome (GBS) were described. In the early stage of demyelinating GBS, the most prominent neurophysiologic feature is the patchy demyelination in the peripheral nerves. Conduction slowing presents in the clinical recovery stage, which indicates the conduction slowing is due to mainly remyelination. Read More

Axonal GBS shows "reversible conduction failure", as well as primary axonal degeneration. "Reversible conduction failure" is thought to be the most common cause of the underestimation of axonal GBS. The electrodiagnostic criteria for GBS subtypes should be revised based on the knowledge acquired in recent years.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1313-20
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine.

Guillain-Barré syndrome can be classified into several phenotypes according to the type of predominantly disturbed nerve fibers, distribution of muscular weakness, and electrophysiological and pathological findings. Although several regional variants including Fisher syndrome and pharyngeal-cervical-brachial weakness were initially reported in Western researchers, many labor-intensive studies by Japanese researchers have significantly contributed to defining and highlighting these variants. This review summarizes the several regional variants of Guillain-Barré syndrome while highlighting the substantial contributions made by Japanese investigators. Read More

Furthermore, a new regional variant named "distal limb weakness" is proposed, in which regional weakness of hands and feet is observed throughout the disease course. It is considered a mild phenotype of acute axonal motor neuropathy after Campylobacter jejuni enteritis.

Brain Nerve
Brain Nerve 2015 Nov;67(11):1305-11
Division of Neurology, Department of Internal Medicine, Hyogo College of Medicine.
Brain Nerve
Brain Nerve 2015 Nov;67(11):1295-303
Department of Neurology, Kindai University Faculty of Medicine.

Guillain-Barré syndrome (GBS) is an acute self-limited polyneuropathy named after Guillain, Barré, and Strohl, who first reported it in 1916. GBS was considered a demyelinating disease until the 1980s, when the acute axonal type of GBS was first reported. Since then, acute inflammatory demyelinating polyneuropathy and acute motor axonal neuropathy have been considered the two main subtypes of GBS. Read More

Autoimmunity underlies the pathogenesis of GBS. The presence of antibodies against various glycolipids in the acute-phase sera from patients with GBS has frequently been reported since the late 1980s. The effectiveness of plasmapheresis and intravenous immunoglobulin therapy has been established since the mid-1980s. However, severe or refractory cases still occur and further investigation is necessary for the development of novel treatments that are effective for such cases.

Indian J Pediatr
Indian J Pediatr 2015 Nov 12. Epub 2015 Nov 12.
Department of Biosciences, COMSATS Institute of Information Technology, Park Road, Chak Shahzad, Islamabad, Pakistan.
Int J Clin Exp Med
Int J Clin Exp Med 2015 15;8(8):14242-5. Epub 2015 Aug 15.
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi Province, China.

We reported a case of hepatic cancer patient with Guillain-Barré syndrome during the perioperative period of partial hepatectomy in the present study. We analyzed the clinical data and described the characteristics of this patient. Read More

J Clin Neurosci
J Clin Neurosci 2015 Nov 5. Epub 2015 Nov 5.
Department of Neurology, Rabin Medical Center, Beilinson Campus 49100, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Morvan's syndrome is a rare neurological condition characterized by the combination of neuromyotonia, autonomic instability and encephalopathy, associated with auto-antibodies against voltage-gated potassium channels. We report a patient with an initial presentation suggestive of typical Guillain-Barré syndrome (GBS), who later developed clinical and laboratory features compatible with Morvan's syndrome. Several months after resolution of the neurological symptoms, as well as disappearance of the characteristic anti-leucine-rich, glioma inactivated 1 (anti-LGI1) antibodies, the patient presented with episodes of fever of unknown origin, during which the antibodies became positive again, suggesting the possibility of a relapse. Read More

In this case, both the GBS-like symptoms at presentation and the isolated episodes of fever of unknown origin during follow-up are atypical, and may suggest the presence of an additional, yet unknown antibody.

Arch Pediatr
Arch Pediatr 2015 Nov 4. Epub 2015 Nov 4.
Service de neuropédiatrie, hôpital Armand-Trousseau, Assistance publique-Hôpitaux de Paris, 26, avenue Arnold-Netter, 75012 Paris, France; Centre de référence de l'Est parisien des maladies neuromusculaires, 75012 Paris, France; DHU i2B (inflammation-immunopathologie-biothérapie), 75012 Paris, France.
Genome Announc
Genome Announc 2015 5;3(6). Epub 2015 Nov 5.
Produce Safety and Microbiology Research Unit, Agricultural Research Service, U.S. Department of Agriculture, Albany, California, USA.

Infections with Campylobacter jejuni subsp. jejuni are a leading cause of foodborne gastroenteritis and the most prevalent infection preceding Guillain-Barré syndrome (GBS). This study describes the genomes of C. Read More

jejuni subsp. jejuni HS:41 strains RM3196 (233.94) and RM3197 (308.95) that were isolated from patients with GBS in Cape Town, South Africa.

Iran J Med Sci
Iran J Med Sci 2015 Nov;40(6):544-7
Senior Resident in Medicine, Department of General Medicine, JSS Medical College, Mysore, Karnataka State, India.

Leptospirosis, a disease of great significance in tropical countries, presents commonly as a biphasic illness with acute febrile episode in the first phase followed by a brief afebrile period and then by the second phase of fever with or without jaundice and renal failure. However, it has varied manifestations and unusual clinical features ascribed to immunological phenomena can occur due to the additional involvement of pulmonary, cardiovascular, and neurological systems. Among the various neurological features, aseptic meningitis is the most common myeloradiculopathy, myelopathy, cerebellar dysfunction, transverse myelitis, Guillain-Barre syndrome, optic neuritis, peripheral neuropathy hare also described. Read More

Cranial neuropathy involving facial nerve is a rare, but known neurological manifestation. Sixth nerve palsy in neuroleptospirosis has so far not been reported. We hereby present the occurrence of bilateral abducent nerve palsy in a patient with leptospirosis.

Value Health
Value Health 2015 Nov 20;18(7):A659-60. Epub 2015 Oct 20.
Dept. of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka State., India.
Int. J. Dev. Neurosci.
Int J Dev Neurosci 2015 Dec;47(Pt A):11
Department of Neurology, First Hospital of Jilin University, China.