title: Cerebrospinal fluid pheresis in Guillain Barré syndrome.
abstract: While plasmapheresis is established in the treatment of acute polyneuroradiculitis, disabling pareses may last long, persisting neurological deficits remain frequent, and costs and side-effects are considerable. Repeated filtration of cerebrospinal fluid may remove pathogenetically relevant cells and polypeptides. Observations in 12 severe Guillain-Barré patients treated with CSF pheresis indicate that it is a safe and effective procedure. We hypothesize mechanisms of action of and potential indications for CSF pheresis as a more general concept. In inflammatory demyelinating polyneuropathy, CSF filtration could be combined with 'dynamic' cerebrospinal fluid pheresis, intravenous immunoglobulin therapy, cryoprecipitation, and/or immuno-adsorption to increase its effectiveness.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, RKU University Academic Hospital, Ulm, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Wollinsky
authors.forename: P J
authors.initials: PJ
authors.lastname: Hülser
authors.forename: M E
authors.initials: ME
authors.lastname: Westarp
authors.forename: H H
authors.initials: HH
authors.lastname: Mehrkens
authors.forename: H H
authors.initials: HH
authors.lastname: Kornhuber
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000134:cerebrospinal fluid / Q000628:therapy; D000936:Antigen-Antibody Complex / Q000032:analysis; D002452:Cell Count; D002469:Cell Separation / Q000379:methods*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D005374:Filtration / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000628:therapy; D010257:Paraneoplastic Syndromes / Q000134:cerebrospinal fluid / Q000628:therapy; D011129:Polyradiculoneuropathy / Q000134:cerebrospinal fluid / Q000628:therapy*
chemical_list: D000936:Antigen-Antibody Complex; D002556:Cerebrospinal Fluid Proteins; D007070:Immunoglobulin A; D007074:Immunoglobulin G