The idiopathic polyradiculoneuropathies: a historical guide to an understanding of the clinical syndromes

Abstract

Recognition of the idiopathic polyradiculoneuropathies began with Graves, Landry and Dumenil who, respectively, suggested, implied and established the peripheral nervous system as a site of disease. Over the ensuing decades other neurologists separated the idiopathic disorders from neuropathies of known cause, poliomyelitis and myelopathies. Guillain, Barré and Strohl described the acute benign syndrome and its cerebrospinal fluid abnormalities. Haymaker & Kernohan solidified the features of the acute disorder as did Dyck et al and Prineas & McLeod for the relapsing and chronic conditions. Currently the idiopathic polyradiculoneuropathies are regarded as autoimmune in nature, clinically generalized with some cases having focal involvement, and of varying severity with only occasional fatalities. Neurologists are divided as to whether the acute and chronic disorders represent 2 different conditions or whether they are 2 forms in the spectrum of a single disorder. This author favors the concept of a single disorder with multifarious manifestations.

Muscle Strength Recovery in Treated Guillain-Barré Syndrome

“…3 The onset of symptoms can either be acute or subacute, and it reaches a plateau with a progressive installation until the maximal point of features called the nadir. 1,2 Primarily characterized by rapidly evolving symmetrical limb weakness, the degree of severity ranges from minimal weakness in the lower legs to total paralysis of the muscles of all limbs and of the trunk, often associated with sensory disturbances and variable autonomic dysfunctions to respiratory insufficiency.…”

“…[5][6][7] Because muscle weakness is the major clinical manifestation during the acute phase of GBS and at long-term follow-up, periodic and objective measurements of muscle strength are necessary to monitor disease progression and response to therapy. 15,21 Although recovery of strength is frequently reported in the GBS population, 3,22 no study to date has objectively and prospectively evaluated muscle strength recovery or motor performance with isokinetic methods in patients with GBS. In this context, the manual muscle testing (MMT) and the Hughes functional scale are usually the main tools used to evaluate clinical status and observe longterm recovery in GBS patients.…”