An appraisal of blood-cerebrospinal fluid barrier dysfunction during the course of Guillain Barré syndrome.
BACKGROUND
Elevated cerebrospinal fluid (CSF) total protein (TP) concentration (mainly due to a dysfunctional blood-CSF barrier (B-CSFB)) with normal cell count is a hallmark for the diagnosis of Guillain-Barriota syndrome (GBS).


OBJECTIVE
This work presents the evaluation of B-CSFB dysfunction with respect to the course, severity, and clinical features of GBS.


METHODS
A sample of CSF was collected on admission from 68 patients of both genders (15 children and 53 adults) diagnosed with GBS. A follow-up CSF sample was obtained approximately 15 days after admission. TP concentration was determined in the CSF and 7.5% polycrylamide gel electrophoresis was employed for serum and CSF protein fractioning. A low percentage of prealbumin fraction was considered a test of impaired B-CSFB.


RESULTS
Elevated TP concentration and lower prealbumin were observed in almost 70% of the patients on admission, but this percentage was lower (52.4%) during the first week from onset of symptoms. Both variables were directly associated with the time of evolution of the disease and also with a greater clinical severity. Follow-up CSF studies showed higher CSF TP and lower prealbumin percentages, while deceased patients did not display this response pattern in the follow-up CSF.


CONCLUSIONS
B-CSFB dysfunction was present in only half of the patients with GBS during the first week from onset and it was directly associated with progression and clinical severity; nevertheless, a low B-CSFB dysfunction response during follow-up was associated with a lethal outcome, suggesting it could also serve a 'protective' effect during regeneration.
Gonzalez-Quevedo
A
A
Department of Neurobiology, Institute of Neurology and Neurosurgery, Havana, Cuba. aglez@infomed.sld.cu
Carriera
R Fernandez
RF
O'Farrill
Z Lestayo
ZL
Luis
I Suarez
IS
Becquer
R Mustelier
RM
Luis Gonzalez
R S
RS
D000293:Adolescent; D000328:Adult; D001812:Blood-Brain Barrier / Q000503:physiopathology; D002556:Cerebrospinal Fluid Proteins / Q000134:cerebrospinal fluid*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011228:Prealbumin / Q000134:cerebrospinal fluid; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
D002556:Cerebrospinal Fluid Proteins; D011228:Prealbumin