title: Clinical classification of 103 Japanese patients with Guillain-Barré syndrome.
abstract: Guillain-Barré syndrome (GBS) is the commonest cause of flaccid paralysis worldwide. Miller Fisher syndrome (MFS) is a variant of GBS characterized by ophthalmoplegia and ataxia. Together GBS and MFS form a continuum of discrete and overlapping subtypes, the frequency of which remains unknown. We retrospectively analysed the clinical features (antecedent symptoms, pattern of neurological weakness or ataxia, presence of hypersomnolence) of 103 patients at a single hospital in Japan. Patients were then classified according to new diagnostic criteria (Wakerley et al., 2014). Laboratory data (neurophysiology and anti-ganglioside antibody profiles) were also analysed. According to the new diagnostic criteria, the 103 patients could be classified as follows: classic GBS 73 (71%), pharyngeal-cervical-brachial weakness 2 (2%), acute pharyngeal weakness 0 (0%), paraparetic GBS 1 (1%), bifacial weakness with paraesthesias 1 (1%), polyneuritis cranialis 0 (0%), classic MFS 18 (17%), acute ophthalmoparesis 1 (1%), acute ptosis 0 (0%), acute mydriasis 0 (0%), acute ataxic neuropathy 1 (1%), Bickerstaff brainstem encephalitis 3 (3%), acute ataxic hypersomnolence 0 (0%), GBS and MFS overlap 1 (1%), GBS and Bickerstaff brainstem encephalitis overlap 1 (1%), MFS and pharyngeal-cervical-brachial weakness overlap 1 (1%). Application of the new clinical diagnostic criteria allowed accurate retrospective diagnosis and classification of GBS and MFS subtypes.
authors.affiliation: Department of Neurology, Gloucestershire Royal Hospital, Gloucester GL13NN, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Wakerley
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kokubun
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Funakoshi
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Neurology, Mishima Hospital, Niigata, Japan. Electronic address: gbs.yuki.cidp@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Yuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D005733:Gangliosidoses / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000097:blood / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000145:classification / Q000175:diagnosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D007074:Immunoglobulin G
keywords: Bifacial weakness with paraesthesias; Guillain-Barré syndrome; Miller Fisher syndrome; Pharyngeal-cervical-brachial weakness