Guillain-Barré Syndrome (GBS)

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

• acute inflammatory polyradiculoneuropathy with resultant weakness and diminished reflexes (demyelinating neuropathy with ascending weakness)
• autoimmune damage of multiple peripheral nerves
• the most important cause of acute flaccid paralysis

Triggering Agents

• Campylobacter jejuni ( usually cause diarrhoea)
• CMV (2nd most common)
• EBV
• others: HIV, mycoplasma species
• ?Vaccination. >>> Influenza and Rabies

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

Features

Initial symptoms

• around 65% of patients experience back/leg pain in the initial stages of the illness
• Often followed after Gastroenteritis or URTISx