Download PDF
Nervenheilkunde 2007; 26(07): 560-566
DOI: 10.1055/s-0038-1626897
Original Article
Schattauer GmbH

Guillain-Barré-Syndrom

Aktuelle Aspekte der Pathogenese, Diagnostik und TherapieGuillain-Barré-Syndromecurrent aspects of pathogenesis, diagnosis, and therapy
J. Dörr
1   Cecilie-Vogt-Klinik für Molekulare Neurologie, Charité Universitätsmedizin Berlin, Neurologische Klinik, HELIOS Klinikum Berlin Buch
,
F. Zipp
1   Cecilie-Vogt-Klinik für Molekulare Neurologie, Charité Universitätsmedizin Berlin, Neurologische Klinik, HELIOS Klinikum Berlin Buch
› Author Affiliations
Further Information

Publication History

Eingegangen am: 12 March 2007

angenommen am: 12 March 2007

Publication Date:
20 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die klinische Entität des Guillain-Barré-Syndroms (GBS) umfasst mindestens vier Subtypen einer peripheren Neuropathie. Hierzu gehören neben der häufigsten akuten inflammatorischen demyelinisierenden Polyneuropathie (AIDP) zwei axonale motorische Varianten mit (AMSAN) oder ohne (AMAN) sensibler Beteiligung und das Miller- Fisher-Syndrom (MFS). Während autoimmunologische Prozesse bei allen Subtypen eine wichtige Rolle spielen, konnten insbesondere bei den axonalen Formen und beim MFS Autoantikörper gegen körpereigene Ganglioside als wesentlicher Pathomechanismus identifiziert werden. Diese Übersicht fasst den aktuellen Wissensstand zur Pathogenese, Diagnostik und Therapie des GBS und seiner Subtypen zusammen.

Summary

The clinical entity of Guillain-Barré-Syndrome (GBS) comprises of at least four subtypes of peripheral neuropathy, including the most frequent acute inflammatory demyelinating polyneuropathy (AIDP), two axonal motor variants with (AMSAN) or without (AMAN) sensory involvement, and the Miller-Fisher-Syndrome (MFS). Autoimmunity plays a major role in the pathogenesis of all subtypes, whereas autoantibodies against gangliosides have been identified as underlying mechanisms in the axonal variants and the MFS. This review summarises the current knowledge with respect to pathogenesis, diagnosis, and therapy of GBS and its subtypes.

Schlüsselwörter

Guillain-Barré-Syndrom - Polyneuropathie - demyelinisierend - axonal - inflammatorisch

Keywords

Guillain-Barré-Syndrom - polyneuropathy - demyelinating - axonal - inflammatory
 

  • Literatur

  • 1 Asahina M, Kuwabara S, Suzuki A, Hattori T. Autonomic function in demyelinating and axonal subtypes of Guillain-Barre syndrome. Acta Neurol Scand 2002; 105: 44-50.
    CrossrefPubMedGoogle Scholar
  • 2 Aspinall GO, McDonald AG, Pang H, Kurjanczyk LA, Penner JL. Lipopolysaccharides of Campylobacter jejuni serotype O:19: structures of core oligosaccharide regions from the serostrain and two bacterial isolates from patients with the Guillain-Barre syndrome. Biochemistry 1994; 33: 241-249.
    CrossrefPubMedGoogle Scholar
  • 3 Bernsen RA, de Jager AE, Schmitz PI, Van der Meche FG. Residual physical outcome and daily living 3 to6 years after Guillain-Barre syndrome. Neurology 1999; 53: 409-410.
    CrossrefPubMedGoogle Scholar
  • 4 Buzby JC, Allos BM, Roberts T. The economic burden of Campylobacter-associated GuillainBarre syndrome. J Infect Dis 1997; 176 Suppl 2: S192-S197.
    PubMedGoogle Scholar
  • 5 Chio A, Cocito D, Leone M, Giordana MT, Mora G, Mutani R. Guillain-Barre syndrome: a prospective, population-based incidence and outcome survey. Neurology 2003; 60: 1146-1150.
    CrossrefPubMedGoogle Scholar
  • 6 Dörr J, Dieste FJ, Klaasen Dvan Husen, Zipp F, Vogel HP. A case of recurrent Miller Fisher syndrome mimicking botulism. Neurol Sci 2006; 27: 424-425.
    CrossrefPubMedGoogle Scholar
  • 7 Durand MC, Porcher R, Orlikowski D, Aboab J, Devaux C, Clair B, Annane D, Gaillard JL, Lofaso F, Raphael JC, Sharshar T. Clinical and electrophysiological predictors of respiratory failure in Guillain-Barre syndrome: a prospective study. Lancet Neurol 2006; 05: 1021-1028.
    CrossrefPubMedGoogle Scholar
  • 8 Esperou H, Jars-Guincestre MC, Bolgert F, Raphael JC, Durand-Zaleski I. Cost analysis of plasma-exchange therapy for the treatment of Guillain-Barre syndrome. French Cooperative Group on Plasma Exchange in Guillain-Barre Syndrome. Intensive Care Med 2000; 26: 1094-1100.
    CrossrefPubMedGoogle Scholar
  • 9 Fisher M. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia and areflexia). N Engl J Med 1956; 255: 57-65.
    CrossrefPubMedGoogle Scholar
  • 10 Gordon PH, Wilbourn AJ. Early electrodiagnostic findings in Guillain-Barre syndrome. Arch Neurol 2001; 58: 913-917.
    CrossrefPubMedGoogle Scholar
  • 11 Griffin JW, Li CY, Ho TW, Tian M, Gao CY, Xue P, Mishu B, Cornblath DR, Macko C, McKhann GM, Asbury AK. Pathology of the motor-sensory axonal Guillain-Barre syndrome. Ann Neurol 1996; 39: 17-28.
    CrossrefPubMedGoogle Scholar
  • 12 Hadden RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, Swan AV. Electrophysiological classification of Guillain-Barre syndrome: clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barre Syndrome Trial Group. Ann Neurol 1998; 44: 780-788.
    CrossrefPubMedGoogle Scholar
  • 13 Hadden RD, Karch H, Hartung HP, Zielasek J, Weissbrich B, Schubert J, Weishaupt A, Cornblath DR, Swan AV, Hughes RA, Toyka KV. Preceding infections, immune factors, and outcome in GuillainBarre syndrome. Neurology 2001; 56: 758-765.
    CrossrefPubMedGoogle Scholar
  • 14 Hafer-Macko CE, Sheikh KA, Li CY, Ho TW, Cornblath DR, McKhann GM, Asbury AK, Griffin JW. Immune attack on the Schwann cell surface in acute inflammatory demyelinating polyneuropathy. Ann Neurol 1996; 39: 625-635.
    CrossrefPubMedGoogle Scholar
  • 15 Hiraga A, Mori M, Ogawara K, Kojima S, Kanesaka T, Misawa S, Hattori T, Kuwabara S. Recovery patterns and long term prognosis for axonal Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2005; 76: 719-722.
    CrossrefPubMedGoogle Scholar
  • 16 Hughes RA, Cornblath DR. Guillain-Barre syndrome. Lancet 2005; 366: 1653-1666.
    CrossrefPubMedGoogle Scholar
  • 17 Hughes RA, Hadden RD, Gregson NA, Smith KJ. Pathogenesis of Guillain-Barre syndrome. J Neuroimmunol 1999; 100: 74-97.
    CrossrefPubMedGoogle Scholar
  • 18 Hughes RA, Raphael JC, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2006 CD002063
    PubMedGoogle Scholar
  • 19 Hughes RA, Swan AV, Van Koningsveld R, van Doorn PA. Corticosteroids for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2006 CD001446
    PubMedGoogle Scholar
  • 20 Hughes RA, Wijdicks EF, Benson E, Cornblath DR, Hahn AF, Meythaler JM, Sladky JT, Barohn RJ, Stevens JC. Supportive care for patients with guillain-barre syndrome. Arch Neurol 2005; 62: 1194-1198.
    CrossrefPubMedGoogle Scholar
  • 21 Jacobs BC, Rothbarth PH, Van der Meche FG, Herbrink P, Schmitz PI, de Klerk MA, van Doorn PA. The spectrum of antecedent infections in Guillain-Barre syndrome: a case-control study. Neurology 1998; 51: 1110-1115.
    CrossrefPubMedGoogle Scholar
  • 22 John TJ. An ethical dilemma in rabies immunisation. Vaccine 1997; (Suppl. 15) S12-S15.
    PubMedGoogle Scholar
  • 23 Kadlubowski RAM Hughes. Identification of the neuritogen for experimental allergic neuritis. Nature 1979; 277: 140-141.
    CrossrefPubMedGoogle Scholar
  • 24 Kaplan JE, Katona P, Hurwitz ES, Schonberger LB. Guillain-Barre syndrome in the United States, 1979-1980 and 1980-1981. Lack of an association with influenza vaccination. JAMA 1982; 248: 698-700.
    CrossrefPubMedGoogle Scholar
  • 25 Kieseier BC, Seifert T, Giovannoni G, Hartung HP. Matrix metalloproteinases in inflammatory demyelination: targets for treatment. Neurology 1999; 53: 20-25.
    CrossrefPubMedGoogle Scholar
  • 26 Kinnunen E, Junttila O, Haukka J, Hovi T. Nationwide oral poliovirus vaccination campaign and the incidence of Guillain-Barre Syndrome. Am J Epidemiol 1998; 147: 69-73.
    CrossrefPubMedGoogle Scholar
  • 27 Koga M, Gilbert M, Li J, Koike S, Takahashi M, Furukawa K, Hirata K, Yuki N. Antecedent infections in Fisher syndrome:a common pathogenesis of molecular mimicry. Neurology 2005; 64: 1605-1611.
    CrossrefPubMedGoogle Scholar
  • 28 Lasky T, Terracciano GJ, Magder L, Koski CL, Ballesteros M, Nash D, Clark S, Haber P, Stolley PD, Schonberger LB, Chen RT. The Guillain-Barre syndrome and the 1992-1993 and 1993–1994 influenza vaccines. N Engl J Med 1998; 339: 1797-1802.
    CrossrefPubMedGoogle Scholar
  • 29 Linington C, Izumo S, Suzuki M, Uyemura K, Meyermann R, Wekerle H. A permanent rat T cell line that mediates experimental allergic neuritis in the Lewis rat in vivo. J Immunol 1984; 133: 1946-1950.
    PubMedGoogle Scholar
  • 30 Lyu RK, Tang LM, Cheng SY, Hsu WC, Chen ST. Guillain-Barre syndrome in Taiwan: a clinical study of 167 patients. J Neurol Neurosurg Psychiatry 1997; 63: 494-500.
    CrossrefPubMedGoogle Scholar
  • 31 McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z, Wu HS, Zhaori G, Liu Y, Jou LP. Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in China. Ann Neurol 1993; 33: 333-342.
    CrossrefPubMedGoogle Scholar
  • 32 Milner P, Lovelidge CA, Taylor WA, Hughes RA. P0 myelin protein produces experimental allergic neuritis in Lewis rats. J Neurol Sci 1987; 79: 275-285.
    CrossrefPubMedGoogle Scholar
  • 33 Mori M, Kuwabara S, Miyake M, Noda M, Kuroki H, Kanno H, Ogawara K, Hattori T. Haemophilus influenzae infection and Guillain-Barre syndrome. Brain 2000; 123 (Pt 10) 2171-2178.
    CrossrefPubMedGoogle Scholar
  • 34 Odaka M, Yuki N, Yamada M, Koga M, Takemi T, Hirata K, Kuwabara S. Bickerstaff’s brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain-Barre syndrome. Brain 2003; 126: 2279-2290.
    CrossrefPubMedGoogle Scholar
  • 35 Olney RK, Aminoff MJ. Electrodiagnostic features of the Guillain-Barre syndrome: the relative sensitivity of different techniques. Neurology 1990; 40: 471-475.
    CrossrefPubMedGoogle Scholar
  • 36 Orlikowski D, Prigent H, Sharshar T, Lofaso F, Raphael JC. Respiratory dysfunction in GuillainBarre Syndrome. Neurocrit Care 2004; 01: 415-422.
    CrossrefPubMedGoogle Scholar
  • 37 Patja A, Paunio M, Kinnunen E, Junttila O, Hovi T, Peltola H. Risk of Guillain-Barre syndrome after measles-mumps-rubella vaccination. J Pediatr 2001; 138: 250-254.
    CrossrefPubMedGoogle Scholar
  • 38 Petzold A, Hinds N, Murray NM, Hirsch NP, Grant D, Keir G, Thompson EJ, Reilly MM. CSF neurofilament levels: a potential prognostic marker in Guillain-Barre syndrome. Neurology 2006; 67: 1071-1073.
    CrossrefPubMedGoogle Scholar
  • 39 Prineas JW. Pathology of the Guillain-Barre syndrome. Ann Neurol 1981; (Suppl. 09) 6-19.
    PubMedGoogle Scholar
  • 40 Pritchard J, Gray IA, Idrissova ZR, Lecky BR, Sutton IJ, Swan AV, Willison HJ, Winer JB, Hughes RA. A randomized controlled trial of recombinant interferon-beta 1a in Guillain-Barre syndrome. Neurology 2003; 61: 1282-1284.
    CrossrefPubMedGoogle Scholar
  • 41 Rees JH, Thompson RD, Smeeton NC, Hughes RA. Epidemiological study of Guillain-Barre syndrome in south east England. J Neurol Neurosurg Psychiatry 1998; 64: 74-77.
    CrossrefPubMedGoogle Scholar
  • 42 Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, Keenlyside RA, Ziegler DW, Retailliau HF, Eddins DL, Bryan JA. Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977. Am J Epidemiol 1979; 110: 105-123.
    CrossrefPubMedGoogle Scholar
  • 43 Sharshar T, Chevret S, Bourdain F, Raphael JC. Early predictors of mechanical ventilation in Guillain-Barre syndrome. Crit Care Med 2003; 31: 278-283.
    CrossrefPubMedGoogle Scholar
  • 44 Tackenberg B, Lünemann JD, Steinbrecher A, Rothenfusser-Korber E, Sailer M, Brück W, Schock S, Zschenderlein R, Zipp F, Sommer N. Classifications and treatment responses in chronic immune mediated demyelinating polyneuropathy. Neurology. 2007 in press.
    PubMedGoogle Scholar
  • 45 Taylor WA, Hughes RA. T lymphocyte activation antigens in Guillain-Barre syndrome and chronic idiopathic demyelinating polyradiculoneuropathy. J Neuroimmunol 1989; 24: 33-39.
    CrossrefPubMedGoogle Scholar
  • 46 Tuttle J, Chen RT, Rantala H, Cherry JD, Rhodes PH, Hadler S. The risk of Guillain-Barre syndrome after tetanus-toxoid-containing vaccines in adults and children in the United States. Am J Public Health 1997; 87: 2045-2048.
    CrossrefPubMedGoogle Scholar
  • 47 Van der Meche FG, Schmitz PI. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barre syndrome. Dutch Guillain-Barre Study Group. N Engl J Med 1992; 326: 1123-1129.
    Google Scholar
  • 48 Van Koningsveld R, Schmitz PI, Meche FG, Visser LH, Meulstee J, van Doorn PA. Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barre syndrome: randomised trial. Lancet 2004; 363: 192-196.
    CrossrefPubMedGoogle Scholar
  • 49 Van Koningsveld R, van Doorn PA, Schmitz PI, Ang CW, Van der Meche FG. Mild forms of Guillain-Barre syndrome in an epidemiologic survey in The Netherlands. Neurology 2000; 54: 620-625.
    CrossrefPubMedGoogle Scholar
  • 50 van Sorge NM, van der Pol WL, Jansen MD, van den Berg LH. Pathogenicity of anti-ganglioside antibodies in the Guillain-Barre syndrome. Autoimmun Rev 2004; 03: 61-68.
    Google Scholar
  • 51 Visser LH, Schmitz PI, Meulstee J, van Doorn PA, Van der Meche FG. Prognostic factors of GuillainBarre syndrome after intravenous immunoglobulin or plasma exchange. Dutch Guillain-Barre Study Group. Neurology 1999; 53: 598-604.
    Google Scholar
  • 52 Willison HJ. The immunobiology of Guillain-Barre syndromes. J Peripher Nerv Syst 2005; 10: 94-112.
    CrossrefPubMedGoogle Scholar
  • 53 Willison HJ, Townson K, Veitch J, Boffey J, Isaacs N, Andersen SM, Zhang P, Ling CC, Bundle DR. Synthetic disialylgalactose immunoadsorbents deplete anti-GQ1b antibodies from autoimmune neuropathy sera. Brain 2004; 127: 680-691.
    PubMedGoogle Scholar
  • 54 Willison HJ, Yuki N. Peripheral neuropathies and anti-glycolipid antibodies. Brain 2002; 125: 2591-2625.
    CrossrefPubMedGoogle Scholar
  • 55 Wollinsky KH, Hulser PJ, Brinkmeier H, Aulkemeyer P, Bossenecker W, Huber-Hartmann KH, Rohrbach P, Schreiber H, Weber F, Kron M, Buchele G, Mehrkens HH, Ludolph AC, Rudel R. CSF filtration is an effective treatment of Guillain-Barre syndrome: a randomized clinical trial. Neurology 2001; 57: 774-780.
    PubMedGoogle Scholar
  • 56 Yuki N, Susuki K, Koga M, Nishimoto Y, Odaka M, Hirata K, Taguchi K, Miyatake T, Furukawa K, Kobata T, Yamada M. Carbohydrate mimicry between human ganglioside GM1 and Campylobacter jejuni lipooligosaccharide causes Guillain-Barre syndrome. Proc Natl Acad Sci U S A 2004; 101: 11404-11409.
    CrossrefPubMedGoogle Scholar