title: A multicentre prospective study of Guillain-Barré syndrome in Japan: a focus on the incidence of subtypes.
abstract: OBJECTIVE
  Guillain-Barré Syndrome (GBS) is classified into the two major subtypes; acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Previous studies have suggested that AIDP is predominant and AMAN is rare in Western countries, whereas AMAN is not always uncommon in East Asia. We aimed to clarify the incidence of the subtypes of GBS in Japan.
  
  
  METHODS
  We performed a prospective multicentre survey over 3 years (2007-2010). Clinical and electrophysiological findings were collected from 184 patients with GBS in 23 tertiary neurology institutes. Anti-ganglioside antibodies were measured by ELISA. We also surveyed the incidence of Fisher syndrome (FS).
  
  
  RESULTS
  By electrodiagnostic criteria of Ho et al, patients were classified as having AIDP (40%), or AMAN (22%), or unclassified (38%). Anti-GM1 IgG antibodies were found for 47% of AMAN patients, and 18% of AIDP patients (p<0.001). There were no specific regional trends of the electrodiagnosis and anti-GM1 positivity. During the same study period, 79 patients with FS were identified; the percentage of FS cases out of all cases (FS/(GBS+FS)) was 26%.
  
  
  CONCLUSIONS
  The frequency of GBS patients with the electrodiagnosis of AMAN by single nerve conduction studies is approximately 20% in Japan, and the AMAN pattern is closely associated with anti-GM1 antibodies. The incidence of FS appears to be much higher in Japan than in Western countries.
authors.affiliation: Faculty of Medicine, Department of Neurology, Kinki University, Osaka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Mitsui
authors.affiliation: Faculty of Medicine, Department of Neurology, Kinki University, Osaka, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
authors.affiliation: Department of Neurology, Ookatsu Hospital, Kagoshima, Japan.
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
authors.affiliation: Department of Neurology, Tokushima University Graduate School of Medicine, Tokushima, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kaji
authors.affiliation: Department of Neurology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Satoshi
authors.identifier: http://orcid.org/0000-0002-4716-8578
authors.initials: S
authors.lastname: Kuwabara
authors.affiliation: Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sonoo
authors.affiliation: Faculty of Medicine, Department of Neurology, Kinki University, Osaka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takada
mesh_terms: D004568:Electrodiagnosis; D005260:Female; D005677:G(M1) Ganglioside / Q000276:immunology; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000145:classification* / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000453:epidemiology; D009046:Motor Neurons / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D011446:Prospective Studies; D063189:Symptom Assessment
chemical_list: D005732:Gangliosides; D007074:Immunoglobulin G; D005677:G(M1) Ganglioside; C039129:GQ1b ganglioside
keywords: CLINICAL NEUROLOGY; EPIDEMIOLOGY; GUILLAIN-BARRE SYNDROME; NEUROPHYSIOL, CLINICAL