Epidemiological and clinical aspects of the Guillain-Barre Syndrome

The Guillain-Barre syndrome (GBS) is an acute immune-mediated disorder of the peripheral nerves. The essential features are a rapidly progressive, more or less symmetrical weakness of the limbs and decreased or absent tendon reflexes. The weakness reaches its nadir (maximum severity) by definition within four weeks, but it is usually seen within two weeks. In 20-30% of the patients, weakness is so severe that artificial ventilation is needed. People of all age, gender or race can be affected by this polyneuropathy. The first symptoms of GBS are often preceded by an infection. Seventy percent of the patients report influenzalike symptoms, a respiratory infection or a gastro-enteritis within the three weeks prior to the onset of the disease. The first description of what is now called the Guillain-Barre syndrome, was given by J.B.O. Landry in 1859 1 . The summation of clinical characteristics was extended by typical findings in the cerebrospinal fluid as described by G. Guillain, JA Barre and A Strohl in 1916 2 • As research progressed, many studies reported on the clinical diversity of GBS. As a consequence, the concept of GBS shifted from a single clinical entity to a disease with heterogeneity in presentation, course and outcome. Nowadays GBS is considered to be a post-infectious immune-mediated acute polyneuropathy with a heterogeneous symptomatology.

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