Axonal degeneration in Guillain–Barré syndrome: a reappraisal

Berciano, José

doi:10.1007/s00415-020-10034-y

Cited by 30 publications

(21 citation statements)

References 98 publications

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“…[20][21][22] Sonographic and autopsy studies offered an alternative pathophysiological explanation for acute pain in AMAN: early inflammatory edema, located in the anterior spinal roots at the neural foramina, the ventral rami of spinal nerves or both, could involve abutting dorsal rami, thus causing nerve trunk pain referred to their innervation territories. 23 In our study, monotherapy with gabapentin had a poor analgesic effect for low back pain, indicating nociceptive pain. Muscle pain in extremities was as prevalent (38.9%) as low back pain in AMAN in the acute phase.…”

Section: Discussionmentioning

confidence: 50%

Pain in acute motor axonal neuropathy

et al. 2021

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Section: Discussionmentioning

confidence: 50%

Pain in acute motor axonal neuropathy

et al. 2021

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“…In the experimental models of allergic polyneuritis, severe inflammatory changes are observed since the 1 st day of presentation, which may explain the rapid and severe progression of symptoms in some patients with GBS 11 . Indeed, there are reports of fulminant GBS which includes rapid progression of symptoms attending the emergency services within hours 12 .…”

Section: Discussionmentioning

confidence: 99%

Very-early Guillain-Barré syndrome: Clinical characteristics, electrophysiological findings, and short-term functional outcome

López-Hernández¹,

May-Mas²,

Galnares-Olalde³

et al. 2021

RMN

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Background: Guillain-Barré syndrome (GBS) patients who present very early (< 4 days) to health-care services generally have severe clinical forms due to rapid progression. Little information exists on the clinical and short-term functional prognosis in patients with very-early GBS (VEGBS). Methods: A prospective cohort study was conducted. We performed Kaplan-Meier survival analysis to observe the recovery of independent gait between groups, where a log-rank value < 0.05 was considered significant. All statistical analyzes were performed using SPSS version 22. Results: Ninety-nine patients were included in the study. Mean age was 46.7 ± 16.7 years, 61.9% were male. Regarding nerve conduction studies, the most frequent electrophysiological variants in the very early-onset GBS group were axonal (38.7%). Twenty-three percent were classified as equivocal. In the GBS group > 4 days, the most frequent electrophysiological variant was acute inflammatory demyelinating polyneuropathy (52.1%). Conclusion: Patients with VEGBS do not present different clinical characteristics, nor severity or poor short-term outcome in our population compared to different GBS presentations. Only mechanical ventilation requirement and distal compound muscle action potential reduction are associated with poor outcome in this subset of patients.

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“…The seminal pathological studies by Haymaker and Kernohan describe that the first pathological event in GBS is the appearance of endoneurial edema in spinal nerves, particularly where the ventral and dorsal rami join to form peripheral nerves. This edema of the ventral rami of the spinal nerves has been proposed to associate with early inexcitability of motor nerves due to proximal nerve ischemia in fulminant GBS cases [93]. After this initial phase, from day 9 onwards, inflammatory infiltrates, including macrophages, appear [94].…”

Section: Immunopathogenesismentioning

confidence: 97%

Novel Immunological and Therapeutic Insights in Guillain-Barré Syndrome and CIDP

Querol

Lleixà

2021

Neurotherapeutics

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Inflammatory neuropathies are a heterogeneous group of rare diseases of the peripheral nervous system that include acute and chronic diseases, such as Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The etiology and pathophysiological mechanisms of inflammatory neuropathies are only partly known, but are considered autoimmune disorders in which an aberrant immune response, including cellular and humoral components, is directed towards components of the peripheral nerve causing demyelination and axonal damage. Therapy of these disorders includes broad-spectrum immunomodulatory and immunosuppressive treatments, such as intravenous immunoglobulin, corticosteroids, or plasma exchange. However, a significant proportion of patients do not respond to any of these therapies, and treatment selection is not optimized according to disease pathophysiology. Therefore, research on disease pathophysiology aiming to reveal clinically and functionally relevant disease mechanisms and the development of new treatment approaches are needed to optimize disease outcomes in CIDP and GBS. This topical review describes immunological progress that may help guide therapeutic strategies in the future in these two disorders. Supplementary Information The online version contains supplementary material available at 10.1007/s13311-021-01117-3.

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Axonal degeneration in Guillain–Barré syndrome: a reappraisal

Cited by 30 publications

References 98 publications

Pain in acute motor axonal neuropathy

Pain in acute motor axonal neuropathy

Very-early Guillain-Barré syndrome: Clinical characteristics, electrophysiological findings, and short-term functional outcome

Novel Immunological and Therapeutic Insights in Guillain-Barré Syndrome and CIDP

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