title: CSF filtration is an effective treatment of Guillain-Barré syndrome: a randomized clinical trial.
abstract: OBJECTIVE
  To compare CSF filtration (CSFF) and plasma exchange (PE) in the treatment of patients with Guillain-Barré syndrome (GBS).
  
  
  METHODS
  In a prospective controlled clinical trial, 37 patients with acute GBS were randomized to receive either CSFF or PE. Inclusion criteria were fulfillment of National Institute of Neurological and Communicative Disorders and Stroke criteria and disability to walk >5 m unassisted.
  
  
  RESULTS
  With similar baseline features in both groups (initial disability grades on the six-point grading scale of the GBS Study Group) the primary outcome variable (improvement within 28 days after randomization) was almost identical (test for equivalence p = 0.0014), the mean grade values being 0.82 in the CSFF group and 0.80 in the PE group. After 56 days, 56% (9 of 16 patients) of the CSFF group and 37% (7 of 19 patients) of the PE group had reached grade 2 (i.e., ability of unassisted walking >5 m). After 6 months, the probability to reach grade 2 was about 80% in both groups. In the CSFF group, transient pleocytosis occurred without apparent clinical complications. Clinically relevant complications were higher in the PE-treated group.
  
  
  CONCLUSIONS
  Although the number of patients was small, the authors found that the treatment of GBS with CSFF is at least as effective as with PE. CSFF might work by removing from the CSF inflammatory mediators, autoantibodies, or other factors.
authors.affiliation: Department of Anesthesiology/Intensive Care, Rehabilitation 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: H
authors.initials: H
authors.lastname: Brinkmeier
authors.forename: P
authors.initials: P
authors.lastname: Aulkemeyer
authors.forename: W
authors.initials: W
authors.lastname: Bössenecker
authors.forename: K H
authors.initials: KH
authors.lastname: Huber-Hartmann
authors.forename: P
authors.initials: P
authors.lastname: Rohrbach
authors.forename: H
authors.initials: H
authors.lastname: Schreiber
authors.forename: F
authors.initials: F
authors.lastname: Weber
authors.forename: M
authors.initials: M
authors.lastname: Kron
authors.forename: G
authors.initials: G
authors.lastname: Büchele
authors.forename: H H
authors.initials: HH
authors.lastname: Mehrkens
authors.forename: A C
authors.initials: AC
authors.lastname: Ludolph
authors.forename: R
authors.initials: R
authors.lastname: Rüdel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid; D016001:Confidence Intervals; D005260:Female; D005374:Filtration / Q000379:methods; D020275:Guillain-Barre Syndrome / Q000097:blood / Q000134:cerebrospinal fluid / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods; D011336:Probability; D016896:Treatment Outcome