Neurológia pre prax 1/2016

Guillain–Barré polyradiculoneuritis

Guillain–Barré syndrome is a disease most commonly associated with symmetric limb weakness, hyporeflexia, and peak manifestations occurring within four weeks of onset. A more modern classification characterizes the disease according to the type and localization of neural structure injury – demyelinating injury in AIDP, axonal injury in AMAN and AMSAN, and typical manifestations in Miller Fisher syndrome. The disease is due to immunogenic-related neural structure injury occurring as a result of the combination of causative factors (e.g., previous infection) and the patient's predisposition to injury. The diagnosis of the disease is based on the clinical presentation, results of electrophysiological investigation of peripheral nerves, and auxiliary laboratory tests – cerebrospinal fluid examination, the presence of anti-ganglioside antibodies, and the like. The course of the disease in the acute phase can be successfully managed by administering plasmapheresis or high-dose intravenous immunoglobulin, with supportive therapy being of importance throughout the disease course. The patient's prognosis is generally good; however, the disease mortality rate remains between 3% and 7%.

Keywords: Guillain–Barré polyradiculoneuritis, AIDP, AMAN, gangliosides, Campylobacter jejuni, plasmapheresis, immunoglobulin