Semin Neurol 2019; 39(05): 589-595
DOI: 10.1055/s-0039-1693005
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Guillain–Barre Syndrome

Elia Malek
1   Department of Neurology, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
,
1   Department of Neurology, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
› Author Affiliations
Further Information

Publication History

Publication Date:
22 October 2019 (online)

Abstract

Guillain–Barre syndrome (GBS) is the leading cause of acute paralysis that can potentially affect all of the human population. GBS is believed to be an immune-mediated disease, possibly triggered by a recent infection, and driven by an immune attack targeting the peripheral nervous system. GBS can be divided into several subtypes depending on the phenotype, pathophysiology, and neurophysiological features. Unfortunately, morbidity and mortality rates are still high despite the current understanding of the pathophysiology and available treatment options. Additional research is still needed to shed more light into the pathogenesis for a better understanding and treatment of this condition.

 
  • References

  • 1 Walusinski O. Pioneering the concepts of stereognosis and polyradiculoneuritis: Octave Landry (1826-1865). Eur Neurol 2013; 70 (5-6): 281-290
  • 2 Hughes RAC, Cornblath DR, Willison HJ. Guillain-Barré syndrome in the 100 years since its description by Guillain, Barré and Strohl. Brain 2016; 139 (11) 3041-3047
  • 3 McGrogan A, Madle GC, Seaman HE, de Vries CS. The epidemiology of Guillain-Barré syndrome worldwide. A systematic literature review. Neuroepidemiology 2009; 32 (02) 150-163
  • 4 Liou LS, Chung CH, Wu YT. , et al. Epidemiology and prognostic factors of inpatient mortality of Guillain-Barré syndrome: a nationwide population study over 14years in Asian country. J Neurol Sci 2016; 369: 159-164
  • 5 Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology 2011; 36 (02) 123-133
  • 6 Webb AJ, Brain SA, Wood R, Rinaldi S, Turner MR. Seasonal variation in Guillain-Barré syndrome: a systematic review, meta-analysis and Oxfordshire cohort study. J Neurol Neurosurg Psychiatry 2015; 86 (11) 1196-1201
  • 7 Shahrizaila N, Yuki N. Bickerstaff brainstem encephalitis and Fisher syndrome: anti-GQ1b antibody syndrome. J Neurol Neurosurg Psychiatry 2013; 84 (05) 576-583
  • 8 Hosokawa T, Nakajima H, Unoda K. , et al. Serial electrophysiological findings in Guillain-Barré syndrome not fulfilling AIDP or AMAN criteria. J Neurol 2016; 263 (09) 1709-1718
  • 9 Mishu B, Ilyas AA, Koski CL. , et al. Serologic evidence of previous Campylobacter jejuni infection in patients with the Guillain-Barré syndrome. Ann Intern Med 1993; 118 (12) 947-953
  • 10 Kuroki S, Saida T, Nukina M. , et al. Campylobacter jejuni strains from patients with Guillain-Barré syndrome belong mostly to Penner serogroup 19 and contain beta-N-acetylglucosamine residues. Ann Neurol 1993; 33 (03) 243-247
  • 11 Ogawara K, Kuwabara S, Mori M, Hattori T, Koga M, Yuki N. Axonal Guillain-Barré syndrome: relation to anti-ganglioside antibodies and Campylobacter jejuni infection in Japan. Ann Neurol 2000; 48 (04) 624-631
  • 12 Griffin JW, Li CY, Ho TW. , et al. Pathology of the motor-sensory axonal Guillain-Barré syndrome. Ann Neurol 1996; 39 (01) 17-28
  • 13 Meyer Sauteur PM, Huizinga R, Tio-Gillen AP. , et al. Mycoplasma pneumoniae triggering the Guillain-Barré syndrome: a case-control study. Ann Neurol 2016; 80 (04) 566-580
  • 14 Hadden RD, Karch H, Hartung HP. , et al; Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Preceding infections, immune factors, and outcome in Guillain-Barré syndrome. Neurology 2001; 56 (06) 758-765
  • 15 Salim OJ, Davidson A, Li K, Leach JP, Heath C. Brainstem encephalitis and acute polyneuropathy associated with hepatitis E infection. BMJ Case Reports. 2017 ;2017
  • 16 Langmuir AD, Bregman DJ, Kurland LT, Nathanson N, Victor M. An epidemiologic and clinical evaluation of Guillain-Barré syndrome reported in association with the administration of swine influenza vaccines. Am J Epidemiol 1984; 119 (06) 841-879
  • 17 Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ. , et al. Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976--1977. Am J Epidemiol 1979; 110 (02) 105-123
  • 18 Vellozzi C, Iqbal S, Broder K. Guillain-Barre syndrome, influenza, and influenza vaccination: the epidemiologic evidence. Clin Infect Dis 2014; 58 (08) 1149-1155
  • 19 Nascimento OJM, da Silva IRF. Guillain-Barré syndrome and Zika virus outbreaks. Curr Opin Neurol 2017; 30 (05) 500-507
  • 20 The Italian Guillain-Barré Study Group. The prognosis and main prognostic indicators of Guillain-Barré syndrome. A multicentre prospective study of 297 patients. Brain 1996; 119 (Pt 6): 2053-2061
  • 21 May SE, Caudle MR, Kleinman GE. Landry-Guillain-Barré-Strohl syndrome in pregnancy. A report of two cases. J Reprod Med 1989; 34 (08) 550-552
  • 22 Ubogu EE, Zaidat OO, Suarez JI. Acute motor-sensory axonal neuropathy associated with active systemic lupus erythematosus and anticardiolipin antibodies. J Clin Rheumatol 2001; 7 (05) 326-331
  • 23 Hafer-Macko C, Hsieh ST, Li CY. , et al. Acute motor axonal neuropathy: an antibody-mediated attack on axolemma. Ann Neurol 1996; 40 (04) 635-644
  • 24 Yuki N, Taki T, Inagaki F. , et al. A bacterium lipopolysaccharide that elicits Guillain-Barré syndrome has a GM1 ganglioside-like structure. J Exp Med 1993; 178 (05) 1771-1775
  • 25 Takigawa T, Yasuda H, Kikkawa R, Shigeta Y, Saida T, Kitasato H. Antibodies against GM1 ganglioside affect K+ and Na+ currents in isolated rat myelinated nerve fibers. Ann Neurol 1995; 37 (04) 436-442
  • 26 Susuki K, Baba H, Tohyama K. , et al. Gangliosides contribute to stability of paranodal junctions and ion channel clusters in myelinated nerve fibers. Glia 2007; 55 (07) 746-757
  • 27 McGonigal R, Rowan EG, Greenshields KN. , et al. Anti-GD1a antibodies activate complement and calpain to injure distal motor nodes of Ranvier in mice. Brain 2010; 133 (Pt 7): 1944-1960
  • 28 Yuki N, Kuwabara S, Koga M, Hirata K. Acute motor axonal neuropathy and acute motor-sensory axonal neuropathy share a common immunological profile. J Neurol Sci 1999; 168 (02) 121-126
  • 29 Fan C, Jin H, Hao H. , et al. Anti-ganglioside antibodies in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy in Chinese patients. Muscle Nerve 2017; 55 (04) 470-475
  • 30 Sawai S, Satoh M, Mori M. , et al. Moesin is a possible target molecule for cytomegalovirus-related Guillain-Barré syndrome. Neurology 2014; 83 (02) 113-117
  • 31 Kawamura N, Yamasaki R, Yonekawa T. , et al. Anti-neurofascin antibody in patients with combined central and peripheral demyelination. Neurology 2013; 81 (08) 714-722
  • 32 Ziganshin RH, Ivanova OM, Lomakin YA. , et al. The pathogenesis of the demyelinating form of Guillain-Barre syndrome (GBS): proteo-peptidomic and immunological profiling of physiological fluids. Mol Cell Proteomics 2016; 15 (07) 2366-2378
  • 33 Yuki N, Taki T, Takahashi M. , et al. Molecular mimicry between GQ1b ganglioside and lipopolysaccharides of Campylobacter jejuni isolated from patients with Fisher's syndrome. Ann Neurol 1994; 36 (05) 791-793
  • 34 Houliston RS, Koga M, Li J. , et al. A Haemophilus influenzae strain associated with Fisher syndrome expresses a novel disialylated ganglioside mimic. Biochemistry 2007; 46 (27) 8164-8171
  • 35 Yoshikawa K, Kuwahara M, Morikawa M. , et al. Varied antibody reactivities and clinical relevance in anti-GQ1b antibody-related diseases. Neurol Neuroimmunol Neuroinflamm 2018; 5 (06) e501
  • 36 Kusunoki S, Chiba A, Kanazawa I. Anti-GQ1b IgG antibody is associated with ataxia as well as ophthalmoplegia. Muscle Nerve 1999; 22 (08) 1071-1074
  • 37 Liu JX, Willison HJ, Pedrosa-Domellöf F. Immunolocalization of GQ1b and related gangliosides in human extraocular neuromuscular junctions and muscle spindles. Invest Ophthalmol Vis Sci 2009; 50 (07) 3226-3232
  • 38 Fukami Y, Wong AH, Funakoshi K, Safri AY, Shahrizaila N, Yuki N. Anti-GQ1b antibody syndrome: anti-ganglioside complex reactivity determines clinical spectrum. Eur J Neurol 2016; 23 (02) 320-326
  • 39 Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria. Brain 2014; 137 (Pt 1): 33-43
  • 40 Wang Y, Shang P, Xin M, Bai J, Zhou C, Zhang HL. The usefulness of chief complaints to predict severity, ventilator dependence, treatment option, and short-term outcome of patients with Guillain-Barré syndrome: a retrospective study. BMC Neurol 2017; 17 (01) 200
  • 41 Anandan C, Khuder SA, Koffman BM. Prevalence of autonomic dysfunction in hospitalized patients with Guillain-Barré syndrome. Muscle Nerve 2017; 56 (02) 331-333
  • 42 Bhargava A, Banakar BF, Pujar GS, Khichar S. A study of Guillain-Barré syndrome with reference to cranial neuropathy and its prognostic implication. J Neurosci Rural Pract 2014; 5 (Suppl. 01) S43-S47
  • 43 Hadden RD, Cornblath DR, Hughes RA. , et al; Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Ann Neurol 1998; 44 (05) 780-788
  • 44 Ho TW, Mishu B, Li CY. , et al. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain 1995; 118 (Pt 3): 597-605
  • 45 Shrivastava M, Nehal S, Seema N. Guillain-Barre syndrome: demographics, clinical profile & seasonal variation in a tertiary care centre of central India. Indian J Med Res 2017; 145 (02) 203-208
  • 46 Mitsui Y, Kusunoki S, Arimura K. , et al; Japanese GBS Study Group. A multicentre prospective study of Guillain-Barré syndrome in Japan: a focus on the incidence of subtypes. J Neurol Neurosurg Psychiatry 2015; 86 (01) 110-114
  • 47 Doets AY, Verboon C, van den Berg B. , et al; IGOS Consortium. Regional variation of Guillain-Barré syndrome. Brain 2018; 141 (10) 2866-2877
  • 48 McKhann GM, Cornblath DR, Griffin JW. , et al. Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in China. Ann Neurol 1993; 33 (04) 333-342
  • 49 Capasso M, Notturno F, Manzoli C, Uncini A. Involvement of sensory fibres in axonal subtypes of Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2011; 82 (06) 664-670
  • 50 Islam Z, Jacobs BC, van Belkum A. , et al. Axonal variant of Guillain-Barre syndrome associated with Campylobacter infection in Bangladesh. Neurology 2010; 74 (07) 581-587
  • 51 Fisher M. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Engl J Med 1956; 255 (02) 57-65
  • 52 Bickerstaff ER. Brain-stem encephalitis; further observations on a grave syndrome with benign prognosis. BMJ 1957; 1 (5032): 1384-1387
  • 53 Wakerley BR, Uncini A, Yuki N. ; GBS Classification Group; GBS Classification Group. Guillain-Barré and Miller Fisher syndromes--new diagnostic classification. Nat Rev Neurol 2014; 10 (09) 537-544
  • 54 Goodfellow JA, Willison HJ. Antiganglioside, antiganglioside-complex, and antiglycolipid-complex antibodies in immune-mediated neuropathies. Curr Opin Neurol 2016; 29 (05) 572-580
  • 55 Gordon PH, Wilbourn AJ. Early electrodiagnostic findings in Guillain-Barré syndrome. Arch Neurol 2001; 58 (06) 913-917
  • 56 Albertí MA, Alentorn A, Martínez-Yelamos S. , et al. Very early electrodiagnostic findings in Guillain-Barré syndrome. J Peripher Nerv Syst 2011; 16 (02) 136-142
  • 57 Uncini A, Ippoliti L, Shahrizaila N, Sekiguchi Y, Kuwabara S. Optimizing the electrodiagnostic accuracy in Guillain-Barré syndrome subtypes: criteria sets and sparse linear discriminant analysis. Clin Neurophysiol 2017; 128 (07) 1176-1183
  • 58 Rajabally YA, Durand MC, Mitchell J, Orlikowski D, Nicolas G. Electrophysiological diagnosis of Guillain-Barré syndrome subtype: could a single study suffice?. J Neurol Neurosurg Psychiatry 2015; 86 (01) 115-119
  • 59 Uncini A, Kuwabara S. The electrodiagnosis of Guillain-Barré syndrome subtypes: where do we stand?. Clin Neurophysiol 2018; 129 (12) 2586-2593
  • 60 Kuwabara S, Yuki N, Koga M. , et al. IgG anti-GM1 antibody is associated with reversible conduction failure and axonal degeneration in Guillain-Barré syndrome. Ann Neurol 1998; 44 (02) 202-208
  • 61 Kuwabara S, Ogawara K, Misawa S. , et al. Sensory nerve conduction in demyelinating and axonal Guillain-Barré syndromes. Eur Neurol 2004; 51 (04) 196-198
  • 62 Byun WM, Park WK, Park BH, Ahn SH, Hwang MS, Chang JC. Guillain-Barré syndrome: MR imaging findings of the spine in eight patients. Radiology 1998; 208 (01) 137-141
  • 63 Mulkey SB, Glasier CM, El-Nabbout B. , et al. Nerve root enhancement on spinal MRI in pediatric Guillain-Barré syndrome. Pediatr Neurol 2010; 43 (04) 263-269
  • 64 Yardimci N, Avci AY, Kayhan E, Benli S. Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain-Barré syndrome. Neurol Sci 2009; 30 (05) 431-433
  • 65 Grimm A, Décard BF, Axer H. Ultrasonography of the peripheral nervous system in the early stage of Guillain-Barré syndrome. J Peripher Nerv Syst 2014; 19 (03) 234-241
  • 66 Razali SNO, Arumugam T, Yuki N, Rozalli FI, Goh KJ, Shahrizaila N. Serial peripheral nerve ultrasound in Guillain-Barré syndrome. Clin Neurophysiol 2016; 127 (02) 1652-1656
  • 67 Rees JH, Thompson RD, Smeeton NC, Hughes RA. Epidemiological study of Guillain-Barré syndrome in south east England. J Neurol Neurosurg Psychiatry 1998; 64 (01) 74-77
  • 68 Walgaard C, Lingsma HF, Ruts L. , et al. Prediction of respiratory insufficiency in Guillain-Barré syndrome. Ann Neurol 2010; 67 (06) 781-787
  • 69 Ruts L, Drenthen J, Jongen JL. , et al; Dutch GBS Study Group. Pain in Guillain-Barre syndrome: a long-term follow-up study. Neurology 2010; 75 (16) 1439-1447
  • 70 Liu J, Wang LN, McNicol ED. Pharmacological treatment for pain in Guillain-Barré syndrome. Cochrane Database Syst Rev 2015; (04) CD009950
  • 71 Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain-Barré syndrome. Cochrane Database Syst Rev 2017; 2: CD001798
  • 72 Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2014; (09) CD002063
  • 73 van der Meché FG, Schmitz PI. ; Dutch Guillain-Barré Study Group. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. N Engl J Med 1992; 326 (17) 1123-1129
  • 74 Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome. Lancet 1997; 349 (9047): 225-230
  • 75 Hughes RA, Brassington R, Gunn AA, van Doorn PA. Corticosteroids for Guillain-Barré syndrome. Cochrane Database Syst Rev 2016; 10: CD001446
  • 76 Misawa S, Kuwabara S, Sato Y. , et al; Japanese Eculizumab Trial for GBS (JET-GBS) Study Group. Safety and efficacy of eculizumab in Guillain-Barré syndrome: a multicentre, double-blind, randomised phase 2 trial. Lancet Neurol 2018; 17 (06) 519-529
  • 77 Walgaard C, Jacobs BC, Lingsma HF, Steyerberg EW, Cornblath DR, van Doorn PA. Second IVIg course in Guillain-Barre syndrome patients with poor prognosis (SID-GBS trial): protocol for a double-blind randomized, placebo-controlled clinical trial. J Peripher Nerv Syst 2018; 23 (04) 210-215