Neuromuscular transmission is not impaired in axonal Guillain--Barré syndrome.
BACKGROUND
Previous studies have shown that anti-GQ1b antibodies induce massive neuromuscular blocking. If anti-GM1 and -GD1a antibodies have similar effects on the neuromuscular junction (NMJ) in human limb muscles, this may explain selective motor involvement in axonal Guillain--Barré syndrome (GBS).


METHODS
Axonal-stimulating single-fibre electromyography was performed in the extensor digitorum communis muscle of 23 patients with GBS, including 13 with the axonal form whose sera had a high titre of serum IgG anti-GM1 or -GD1a antibodies.


RESULTS
All patients with axonal or demyelinating GBS showed normal or near-normal jitter, and no blocking.


CONCLUSIONS
In both axonal and demyelinating GBS, neuromuscular transmission is not impaired. Our results failed to support the hypothesis that anti-GM1 or -GD1a antibody affects the NMJ. In GBS, impulse transmission is presumably impaired in the motor nerve terminal axons proximal to the NMJ.
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. kuwabara-s@faculty.chiba-u.jp
Satoshi
S
Kuwabara
N
N
Kokubun
S
S
Misawa
K
K
Kanai
S
S
Isose
K
K
Shibuya
Y
Y
Noto
M
M
Mori
Y
Y
Sekiguchi
S
S
Nasu
Y
Y
Fujimaki
K
K
Hirata
N
N
Yuki
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001369:Axons / Q000502:physiology*; D004576:Electromyography; D005260:Female; D005677:G(M1) Ganglioside / Q000031:analogs & derivatives / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D009469:Neuromuscular Junction / Q000503:physiopathology*; D009435:Synaptic Transmission / Q000502:physiology*; D055815:Young Adult
D001323:Autoantibodies; D007074:Immunoglobulin G; C064020:ganglioside GD1alpha; D005677:G(M1) Ganglioside