Guillain Barre Syndrome Types - OmniMedicalSearch.com

Conditions & Diseases: Brain & Nervous System

Guillain Barré Syndrome

Types of Guillain-Barre Syndrome

Guillain-Barre Syndrome has several variants depending on their symptoms, preceding infection, duration of inflammatory phase, severity, they are less common in children than in adults. There are two types of variants:

I. Variants with Rapid Progressive Phase

II. Variants with Slow Progressive Phase (6)

I. Variants with Rapid Progressive Phase are:

1. Acute inflammatory demyelineating polyneuropathy (AIDP): This sub-type is preceded by bacterial or viral infection. About 40% patients are seropositive for Campylobacter jejuni with lymphocytic infiltration and macrophage-mediated demyelination of the peripheral nerves.

2. Acute motor axonal neuropathy (AMAN): This is a purely motor sub-type prevalent among small children. About 70-75% are seropositive for Campylobacter with one third of the cases being hyperreflexic.

3. Acute motor-sensory axonal neuropathy (AMSAN): This is an acute severe illness affecting sensory nerves and roots.

Patients are generally adults with both motor and sensory dysfunction, marked muscle wasting and poor recovery.

4. Miller-Fisher Syndrome (MFS): This is a rare variant with classic triad consisting of ataxia, areflexia and ophthalmoplegia. Ataxia leads to a degree of sensory loss and the patients suffer from mild limb weakness, ptosis, facial palsy or bulbar palsy.

5. Acute Panautomatic Neuropathy: This is the rarest of all variants affecting the sympathetic and parasympathetic nervous systems. “Cardiovascular involvement is common and dysrhythmias are a significant source of mortality in this form of the disease” (6 & 3).

II. Variants with Slow Progressive Phase

1. Recurrent Guillain-Barre Syndrome (RGBS) or Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP): Patients having suffered more than 32 episodes of Guillain-Barre attacks are classified of suffering from RGBS or CIDP. Patients with RGBS exhibit rapid onset of symptoms, high incidence of antecedent illness, lack of response to immunosuppressive therapy and normal cerebral spinal fluid protein levels at the onset of recurrence. It is important to note that the patients also exhibit near complete recovery (5).

2. Multifocal Motor Neuropathy (MMN): This is a rare form of RGBS with limbs weakening gradually in a random pattern.

3. Multifocal Motor Sensory Demyelinating Neuropathy (MMSD): This is also a rare form of RGBS causing weakness along with sensory disturbances.

4. Multifocal Acquired Demyelinating Sensory Acquired Neuropathy (MADSAM): This is a subtype of CIDP and also known as Lewis-Sumner Syndrome or Multifocal CIDP. It is gradually progressive or relapsing-remitting.

5. Paraproteinaemic Demyelinating Neuropathy(PDN): This is a subtype of CIDP and also known as Monoclonal Gammopathy of Unknown Significance (MGUS) in the US. It is gradually progressive in the three main types of antibodies of Immunoglobulin (i.e., IgM, IgG and IgA) with the last two types being relapsing-remitting (6).

Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com