guillain barre syndrome

Summary

Summary: An acute inflammatory autoimmune neuritis caused by T cell- mediated cellular immune response directed towards peripheral myelin. Demyelination occurs in peripheral nerves and nerve roots. The process is often preceded by a viral or bacterial infection, surgery, immunization, lymphoma, or exposure to toxins. Common clinical manifestations include progressive weakness, loss of sensation, and loss of deep tendon reflexes. Weakness of respiratory muscles and autonomic dysfunction may occur. (From Adams et al., Principles of Neurology, 6th ed, pp1312-1314)

Top Publications

  1. van Koningsveld R, Steyerberg E, Hughes R, Swan A, van Doorn P, Jacobs B. A clinical prognostic scoring system for Guillain-Barré syndrome. Lancet Neurol. 2007;6:589-94 pubmed
    ..We aimed to develop and validate a scoring system based on clinical characteristics in the acute phase of GBS to predict outcome at 6 months...
  2. Brannagan T, Zhou Y. HIV-associated Guillain-Barré syndrome. J Neurol Sci. 2003;208:39-42 pubmed
    ..A mild cerebrospinal fluid (CSF) pleocytosis in GBS suggests HIV infection, but is frequently absent. Compared to HIV-negative people, HIV-GBS may be associated with more frequent recurrent episodes or the development of CIDP...
  3. Hughes R, Cornblath D. Guillain-Barré syndrome. Lancet. 2005;366:1653-66 pubmed
    ..Further research is needed to discover treatments to prevent 20% of patients from being left with persistent and significant disability...
  4. Rekand T, Gramstad A, Vedeler C. Fatigue, pain and muscle weakness are frequent after Guillain-Barré syndrome and poliomyelitis. J Neurol. 2009;256:349-54 pubmed publisher
    ..We studied fatigue, pain and muscular weakness in both conditions to define possible interactions between these symptoms and their influence on residual disability and daily functioning...
  5. Souayah N, Nasar A, Suri M, Qureshi A. Guillain-Barre syndrome after vaccination in United States a report from the CDC/FDA Vaccine Adverse Event Reporting System. Vaccine. 2007;25:5253-5 pubmed
    ..We conclude that vaccines other than influenza vaccine can be associated with GBS...
  6. Burns T. Guillain-Barré syndrome. Semin Neurol. 2008;28:152-67 pubmed publisher
    ..Intravenous immunoglobulin and plasma exchange are efficacious treatments. Supportive care during and following hospitalization is also crucial...
  7. Koga M, Yuki N. Campylobacter jejuni cst-II polymorphisms and association with development of Guillain-Barré syndrome. Neurology. 2007;69:1727-8; author reply 1728 pubmed
  8. Yuki N, Kuwabara S. Axonal Guillain-Barré syndrome: carbohydrate mimicry and pathophysiology. J Peripher Nerv Syst. 2007;12:238-49 pubmed
    ..Immunological, pathological, electrophysiological, and bacteriological studies have provided strong evidence of carbohydrate mimicry being a cause of AMAN and clarified the mechanisms of nerve conduction failure in AMAN...
  9. Jin T, Hu L, Chang M, Wu J, Winblad B, Zhu J. Proteomic identification of potential protein markers in cerebrospinal fluid of GBS patients. Eur J Neurol. 2007;14:563-8 pubmed
    ..We concluded that these six proteins may be involved in the pathogenesis of GBS and call for further studying the role of these proteins in the pathogenesis of the disease...

More Information

Publications62

  1. Yuki N. Ganglioside mimicry and peripheral nerve disease. Muscle Nerve. 2007;35:691-711 pubmed
    ..Acute and chronic inflammatory demyelinating polyneuropathies may be produced by mechanisms other than ganglioside mimicry...
  2. Bussmann J, Garssen M, van Doorn P, Stam H. Analysing the favourable effects of physical exercise: relationships between physical fitness, fatigue and functioning in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. J Rehabil Med. 2007;39:121-5 pubmed
  3. Dhar R, Stitt L, Hahn A. The morbidity and outcome of patients with Guillain-Barré syndrome admitted to the intensive care unit. J Neurol Sci. 2008;264:121-8 pubmed
    ..One third of patients with Guillain-Barré syndrome (GBS) require admission to the intensive care unit (ICU), associated with significant risk of morbidity, mortality, and incomplete recovery...
  4. Nachamkin I, Arzarte Barbosa P, Barbosa P, Ung H, Ung H, Lobato C, et al. Patterns of Guillain-Barre syndrome in children: results from a Mexican population. Neurology. 2007;69:1665-71 pubmed
    ..Previous clinical studies suggested that AMAN also occurs in Mexican children. The purpose of this study was to describe the subtypes of GBS in children from Mexico City...
  5. Markoula S, Giannopoulos S, Sarmas I, Tzavidi S, Kyritsis A, Lagos G. Guillain-Barré syndrome in northwest Greece. Acta Neurol Scand. 2007;115:167-73 pubmed
    ..We present the epidemiological and clinical-laboratory features of Guillain-Barré syndrome (GBS) in northwest Greece over a 9.5-year period...
  6. Taboada E, van Belkum A, Yuki N, Acedillo R, Godschalk P, Koga M, et al. Comparative genomic analysis of Campylobacter jejuni associated with Guillain-Barré and Miller Fisher syndromes: neuropathogenic and enteritis-associated isolates can share high levels of genomic similarity. BMC Genomics. 2007;8:359 pubmed
    ..jejuni factors associated with GBS/MFS to date and has allowed us to analyze the genetic background of neuropathogenic C. jejuni strains with an unprecedented level of resolution...
  7. Kaida K, Ariga T, Yu R. Antiganglioside antibodies and their pathophysiological effects on Guillain-Barré syndrome and related disorders--a review. Glycobiology. 2009;19:676-92 pubmed publisher
    ..While GBS is not considered a genetic disease, host factors, particularly human lymphocyte antigen type, appear to have a role in the pathogenesis of GBS following C. jejuni infection...
  8. van Doorn P, Ruts L, Jacobs B. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol. 2008;7:939-50 pubmed publisher
    ..Advances in prognostic modelling have resulted in the development of a new and simple prognostic outcome scale that might also help to guide new treatment options, particularly in patients with GBS who have a poor prognosis...
  9. Yang Y, Liu S, Qin Z, Liu F, Qin Y, Bai S, et al. Comparative proteomics analysis of cerebrospinal fluid of patients with Guillain-Barré syndrome. Cell Mol Neurobiol. 2008;28:737-44 pubmed publisher
    ..These identified proteins may be involved in the pathophysiological process of GBS and call for further studying the role of these proteins in the pathogenesis of the disease...
  10. Cheng Q, Wang D, Jiang G, Han H, Zhang Y, Wang W, et al. Prospective study of clinical epidemiology of Guillain-Barré syndrome in Harbin, China. J Neurol Sci. 2003;215:63-9 pubmed
    ..Clinical and epidemiological differences of GBS might exist between various populations...
  11. Gilbert M, Godschalk P, Karwaski M, Ang C, van Belkum A, Li J, et al. Evidence for acquisition of the lipooligosaccharide biosynthesis locus in Campylobacter jejuni GB11, a strain isolated from a patient with Guillain-Barré syndrome, by horizontal exchange. Infect Immun. 2004;72:1162-5 pubmed
    ..These data indicate that the antiganglioside response in the GB11-infected patient was raised against the structures synthesized by the acquired class A LOS locus...
  12. Garssen M, Schillings M, van Doorn P, van Engelen B, Zwarts M. Contribution of central and peripheral factors to residual fatigue in Guillain-Barré syndrome. Muscle Nerve. 2007;36:93-9 pubmed
    ..This study thus provides further insight into the factors contributing to residual fatigue in GBS patients...
  13. Garssen M, Bussmann J, Schmitz P, Zandbergen A, Welter T, Merkies I, et al. Physical training and fatigue, fitness, and quality of life in Guillain-Barré syndrome and CIDP. Neurology. 2004;63:2393-5 pubmed
    ..Training seemed well tolerated, and self-reported fatigue scores decreased 20% (p = 0.001). Physical fitness, functional outcome, and quality of life were improved...
  14. Shu X, Cai F, Zhang X. Carbohydrate mimicry of Campylobacter jejuni lipooligosaccharide is critical for the induction of anti-GM1 antibody and neuropathy. Muscle Nerve. 2006;33:225-31 pubmed
    ..These results indicate that ganglioside-mimicry structures in C. jejuni LOS are necessary for induction of antiganglioside antibody response and neuropathy...
  15. Csurhes P, Sullivan A, Green K, Pender M, McCombe P. T cell reactivity to P0, P2, PMP-22, and myelin basic protein in patients with Guillain-Barre syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry. 2005;76:1431-9 pubmed
  16. Parker C, Horn S, Gilbert M, Miller W, Woodward D, Mandrell R. Comparison of Campylobacter jejuni lipooligosaccharide biosynthesis loci from a variety of sources. J Clin Microbiol. 2005;43:2771-81 pubmed
    ..Analysis of the LOS biosynthesis genes by PCR assays can be used for typing C. jejuni and offers the advantage of inferring potential LOS structures...
  17. Machado F, Valerio B, Morgulis R, Nunes K, Mazzali Verst S. Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery. Arq Neuropsiquiatr. 2006;64:609-12 pubmed
    ..We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients...
  18. Hadden R, Hughes R. Management of inflammatory neuropathies. J Neurol Neurosurg Psychiatry. 2003;74 Suppl 2:ii9-ii14 pubmed
  19. Geier M, Geier D, Zahalsky A. Influenza vaccination and Guillain Barre syndrome. Clin Immunol. 2003;107:116-21 pubmed
    Acute and severe Guillain Barre Syndrome (GBS) cases reported following influenza vaccine to the Vaccine Adverse Events Reporting System (VAERS) database from 1991 through 1999 were examined...
  20. Hughes R, Charlton J, Latinovic R, Gulliford M. No association between immunization and Guillain-Barré syndrome in the United Kingdom, 1992 to 2000. Arch Intern Med. 2006;166:1301-4 pubmed
    ..Our goal was to determine whether immunization is associated with the incidence of Guillain-Barré syndrome (GBS)...
  21. Siddiqui A, Usmani R, Anwer S, Afsar S. Guillain-Barre syndrome occurring after rabies vaccination. J Pak Med Assoc. 2005;55:87-8 pubmed
    ..We report a case of Guillain-Barre syndrome secondary to sheep brain anti-rabies vaccine in a young boy, who presented with lower limb weakness with total recovery after treatment...
  22. Geleijns K, Schreuder G, Jacobs B, Sintnicolaas K, van Koningsveld R, Meulstee J, et al. HLA class II alleles are not a general susceptibility factor in Guillain-Barré syndrome. Neurology. 2005;64:44-9 pubmed
    ..To assess whether human leukocyte antigen (HLA)-DRB1 and HLA-DQB1 alleles confer susceptibility to Guillain-Barre syndrome (GBS) or are related to specific clinical or serologic subgroups of GBS...
  23. Forsberg A, Press R, Einarsson U, de Pedro Cuesta J, Widen Holmqvist L. Impairment in Guillain-Barré syndrome during the first 2 years after onset: a prospective study. J Neurol Sci. 2004;227:131-8 pubmed
    ..To provide a comprehensive description of impairment in patients with Guillain-Barre syndrome (GBS) in Sweden during the first 2 years after disease onset...
  24. Geleijns K, Brouwer B, Jacobs B, Houwing Duistermaat J, van Duijn C, Van Doorn P. The occurrence of Guillain-Barre syndrome within families. Neurology. 2004;63:1747-50 pubmed
    ..The authors observed an earlier onset of GBS in successive generations. The occurrence of GBS within families suggests a role for genetic factors in the pathogenesis of GBS...
  25. Kabore R, Magy L, Boukhris S, Mabrouk T, Lacoste M, Vallat J. [Contribution of corticosteroid to the treatment of pain in the acute phase of Guillain-Barré syndrome]. Rev Neurol (Paris). 2004;160:821-3 pubmed
    ..We report four patients with GBS whose pain was rapidly relieved by administration of corticosteroids...
  26. Inglis H, Csurhes P, McCombe P. Antibody responses to peptides of peripheral nerve myelin proteins P0 and P2 in patients with inflammatory demyelinating neuropathy. J Neurol Neurosurg Psychiatry. 2007;78:419-22 pubmed
  27. Yu R, Usuki S, Ariga T. Ganglioside molecular mimicry and its pathological roles in Guillain-Barré syndrome and related diseases. Infect Immun. 2006;74:6517-27 pubmed
  28. Somarajan A. Guillain Barre syndrome with brisk reflexes-another variant. Neurol India. 2006;54:215-6 pubmed
  29. Godschalk P, Kuijf M, Li J, St Michael F, Ang C, Jacobs B, et al. Structural characterization of Campylobacter jejuni lipooligosaccharide outer cores associated with Guillain-Barre and Miller Fisher syndromes. Infect Immun. 2007;75:1245-54 pubmed
    ..jejuni-related GBS. However, our findings suggest that in some cases, other mechanisms may play a role. Further examination of the disease etiology in these patients is mandatory...
  30. Koga M, Gilbert M, Takahashi M, Li J, Koike S, Hirata K, et al. Comprehensive analysis of bacterial risk factors for the development of Guillain-Barre syndrome after Campylobacter jejuni enteritis. J Infect Dis. 2006;193:547-55 pubmed
    ..Guillain-Barre syndrome (GBS), a postinfectious autoimmune-mediated neuropathy, is a serious complication after Campylobacter jejuni enteritis...
  31. Pandey C, Bose N, Garg G, Singh N, Baronia A, Agarwal A, et al. Gabapentin for the treatment of pain in guillain-barré syndrome: a double-blinded, placebo-controlled, crossover study. Anesth Analg. 2002;95:1719-23, table of contents pubmed
    ..11 +/- 21.39 to 65.53 +/- 16.17 [ micro g]) in comparison to the placebo therapy period (319.44 +/- 25.08 to 316.67 +/- 24.25 [ micro g]) (P < 0.001)...
  32. Yuki N. Carbohydrate mimicry: a new paradigm of autoimmune diseases. Curr Opin Immunol. 2005;17:577-82 pubmed
    ..This new concept that carbohydrate mimicry can cause an autoimmune disease provides a clue to inducing the resolution of pathogenesis of other immune-mediated diseases...
  33. van Sorge N, van der Pol W, Jansen M, Geleijns K, Kalmijn S, Hughes R, et al. Severity of Guillain-Barré syndrome is associated with Fc gamma Receptor III polymorphisms. J Neuroimmunol. 2005;162:157-64 pubmed
    ..Results suggest that Fc gammaRIII genotypes may represent mild disease-modifying factors in GBS...
  34. Godschalk P, Heikema A, Gilbert M, Komagamine T, Ang C, Glerum J, et al. The crucial role of Campylobacter jejuni genes in anti-ganglioside antibody induction in Guillain-Barre syndrome. J Clin Invest. 2004;114:1659-65 pubmed
    ..We demonstrate, for the first time, to our knowledge, that specific bacterial genes are crucial for the induction of anti-ganglioside antibodies...
  35. van Koningsveld R, Schmitz P, Meché F, Visser L, Meulstee J, Van Doorn P. Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barré syndrome: randomised trial. Lancet. 2004;363:192-6 pubmed
    ..Our aim was to assess whether methylprednisolone, when taken with IVIg, improves outcome when compared with IVIg alone...
  36. Duim B, Godschalk P, van den Braak N, Dingle K, Dijkstra J, Leyde E, et al. Molecular evidence for dissemination of unique Campylobacter jejuni clones in Curaçao, Netherlands Antilles. J Clin Microbiol. 2003;41:5593-7 pubmed
    ..Furthermore, given the observation that C. jejuni-associated diseases appear to be more severe from November to February, it can be speculated that this may be due to the presence of virulent clones with a limited span of circulation...
  37. Cheng B, Chang W, Chang C, Chee C, Huang C, Chen J, et al. Guillain-Barré syndrome in southern Taiwan: clinical features, prognostic factors and therapeutic outcomes. Eur J Neurol. 2003;10:655-62 pubmed
    ..Therefore, early diagnosis, choice of appropriate treatment, and preventing complications during acute stages are essential to maximize the potential for survival...
  38. Garssen M, Schmitz P, Merkies I, Jacobs B, van der Meche F, Van Doorn P. Amantadine for treatment of fatigue in Guillain-Barre syndrome: a randomised, double blind, placebo controlled, crossover trial. J Neurol Neurosurg Psychiatry. 2006;77:61-5 pubmed
    ..In this trial, the effect of amantadine on severe fatigue related to GBS was studied...
  39. Garssen M, Van Doorn P, Visser G. Nerve conduction studies in relation to residual fatigue in Guillain-Barré syndrome. J Neurol. 2006;253:851-6 pubmed
    ..This study demonstrates that fatigue in GBS is not explained by residual nerve dysfunction, using conventional NC measurements...
  40. Godschalk P, Bergman M, Gorkink R, Simons G, van den Braak N, Lastovica A, et al. Identification of DNA sequence variation in Campylobacter jejuni strains associated with the Guillain-Barré syndrome by high-throughput AFLP analysis. BMC Microbiol. 2006;6:32 pubmed
    ..This study describes a new C. jejuni-specific high-throughput AFLP (htAFLP) approach for detection and identification of DNA polymorphism, in general, and of putative GBS/MFS-markers, in particular...
  41. Phongsisay V, Perera V, Fry B. Exchange of lipooligosaccharide synthesis genes creates potential Guillain-Barre syndrome-inducible strains of Campylobacter jejuni. Infect Immun. 2006;74:1368-72 pubmed
  42. Koga M, Takahashi M, Masuda M, Hirata K, Yuki N. Campylobacter gene polymorphism as a determinant of clinical features of Guillain-Barré syndrome. Neurology. 2005;65:1376-81 pubmed
    ..A C jejuni gene, cst-II, involved in the biosynthesis of ganglioside-like lipo-oligosaccharide, shows a polymorphism (Asn/Thr51) that affects ganglioside epitopes...
  43. Susuki K, Odaka M, Mori M, Hirata K, Yuki N. Acute motor axonal neuropathy after Mycoplasma infection: Evidence of molecular mimicry. Neurology. 2004;62:949-56 pubmed
    ..Patients with Guillain-Barré syndrome (GBS) after Mycoplasma pneumoniae infection often have antibodies to galactocerebroside (GalC). Electrodiagnosis may show acute inflammatory demyelinating polyneuropathy (AIDP)...
  44. Magira E, Papaioakim M, Nachamkin I, Asbury A, Li C, Ho T, et al. Differential distribution of HLA-DQ beta/DR beta epitopes in the two forms of Guillain-Barré syndrome, acute motor axonal neuropathy and acute inflammatory demyelinating polyneuropathy (AIDP): identification of DQ beta epitopes associated with suscep. J Immunol. 2003;170:3074-80 pubmed
  45. Tam C, Rodrigues L, Petersen I, Islam A, Hayward A, O Brien S. Incidence of Guillain-Barré syndrome among patients with Campylobacter infection: a general practice research database study. J Infect Dis. 2006;194:95-7 pubmed
    ..17/1000 person-years, a rate 77 times greater than that in the general population. The probability that an individual who develops Campylobacter enteritis will also develop GBS during the subsequent 2-month period is <2/10,000...
  46. Soehardy Z, Yuhanisa A, Thein S, Rohana A, Fauzi A, Norlinah M, et al. AMSAN variant of Guillain Barre syndrome progressing to chronic inflammatory demyelinating polyneuropathy in a patient with Marfan's syndrome and pulmonary tuberculosis. Med J Malaysia. 2005;60:655-6 pubmed
    ..Nerve conduction, MRI and CSF studies were done to confirm a first case report of AMSAN variant progressing to CIDP in a patient with Marfan's syndrome and pulmonary tuberculosis...
  47. Yuki N, Susuki K, Koga M, Nishimoto Y, Odaka M, Hirata K, et al. Carbohydrate mimicry between human ganglioside GM1 and Campylobacter jejuni lipooligosaccharide causes Guillain-Barre syndrome. Proc Natl Acad Sci U S A. 2004;101:11404-9 pubmed
    ..These findings show that carbohydrate mimicry is an important cause of autoimmune neuropathy...
  48. Müller H, Beckmann A, Schroder J. Inflammatory infiltrates in the spinal cord of patients with Guillain-Barré syndrome. Acta Neuropathol. 2003;106:509-17 pubmed
    ..Insignificant cellular infiltrates in the spinal cord were noted in the other two GBS cases. Focal cellular infiltration of spinal nerve roots and meninges was similar in all cases...
  49. Tam C, Rodrigues L, O Brien S. Guillain-Barré syndrome associated with Campylobacter jejuni infection in England, 2000-2001. Clin Infect Dis. 2003;37:307-10 pubmed
    ..jejuni. We estimate that, between 1 April 2000 and 31 March 2001, symptomatic C. jejuni infection was responsible for 157 cases of GBS, constituting approximately 15% of all GBS cases in England...
  50. Jeha L, Sila C, Lederman R, Prayson R, Isada C, Gordon S. West Nile virus infection: a new acute paralytic illness. Neurology. 2003;61:55-9 pubmed
    ..To determine the clinical, laboratory, electrodiagnostic, radiologic, and pathologic characteristics that define the spectrum of CNS disease caused by West Nile virus (WNV) infection...
  51. Garssen M, van Koningsveld R, Van Doorn P. Residual fatigue is independent of antecedent events and disease severity in Guillain-Barré syndrome. J Neurol. 2006;253:1143-6 pubmed
    ..01). There was no significant relationship between fatigue severity and the level of functional disability at nadir, antecedent events or infections, clinical variables, and time to follow-up after GBS...
  52. Pandey C, Raza M, Tripathi M, Navkar D, Kumar A, Singh U. The comparative evaluation of gabapentin and carbamazepine for pain management in Guillain-Barré syndrome patients in the intensive care unit. Anesth Analg. 2005;101:220-5, table of contents pubmed
    ..05). We conclude that gabapentin is more effective than carbamazepine for decreasing pain and fentanyl consumption...
  53. Taylor B, Williamson J, Luck J, Coleman D, Jones D, McGregor A. Sensitivity and specificity of serology in determining recent acute Campylobacter infection. Intern Med J. 2004;34:250-8 pubmed
    ..has been used to investigate links between prior Campylobacter infections and the development of Guillain-Barre syndrome and its variants. Little is known of the serum antibody response to acute infections in the short- or long-term...