title: Demyelinating Guillain-Barré syndrome recurs more frequently than axonal subtypes.
abstract: Guillain-Barré syndrome (GBS) is considered a monophasic disorder yet recurrences occur in up to 6% of patients. We retrospectively studied an Italian-Japanese population of 236 GBS and 73 Miller Fisher syndrome (MFS) patients and searched for factors which may be associated with recurrence. A recurrent patient was defined as having at least two episodes that fulfilled the diagnostic criteria for GBS and MFS with an identifiable recovery after each episode and a minimum of 2months between episodes. Preceding Campylobacter jejuni (C. jejuni) infection and antiganglioside antibodies were also assessed. Seven (3%) recurrent GBS and one (1.4%) recurrent MFS patients were identified. In the individual patient the clinical features during episodes were usually similar varying in severity whereas the preceding infection differed. None of the patients had GBS in one episode and MFS in the recurrence or vice versa. Recurrent GBS patients, compared with monophasic GBS, did not have preceding diarrhea at the first episode and considering the electrophysiological subtypes, acute inflammatory demyelinating polyneuropathies recurred more frequently than axonal GBS (6.5% vs 0.9%, p=0.04). In conclusion in a GBS population with a balanced number of demyelinating and axonal subtypes less frequent diarrhea and demyelination at electrophysiology were associated with recurrence.
authors.affiliation: Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy. Electronic address: francnotturno@yahoo.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Notturno
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kokubun
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Sekiguki
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: De Lauretis
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.affiliation: Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Uncini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000378:metabolism; D002169:Campylobacter Infections / Q000453:epidemiology / Q000276:immunology; D002648:Child; D004558:Electric Stimulation; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology*; D012008:Recurrence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000906:Antibodies; D005732:Gangliosides
keywords: Acute inflammatory demyelinating polyneuropathy; Axonal Guillain-Barré syndrome; Guillain-Barré syndrome; Miller Fisher syndrome; Recurrence