Guillain-Barre syndrome

Guillain-Barre syndrome describes an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni)

Pathogenesis

• cross-reaction of antibodies with gangliosides in the peripheral nervous system
• correlation between anti-ganglioside antibody (e.g. anti-GM1) and clinical features has been demonstrated
• anti-GM1 antibodies in 25% of patients

Miller Fisher syndrome

• variant of Guillain-Barre syndrome
• associated with ophthalmoplegia, areflexia and ataxia. The eye muscles are typically affected first
• usually presents as a descending paralysis rather than ascending as seen in other forms of Guillain-Barre syndrome
• anti-GQ1b antibodies are present in 90% of cases