PMID- 11096775
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220801
IS  - 1092-8480 (Print)
IS  - 1092-8480 (Linking)
VI  - 2
IP  - 6
DP  - 2000 Nov
TI  - Guillain-Barre Syndrome.
PG  - 507-516
AB  - Guillain-Barre syndrome (GBS) is an acute immune-mediated polyneuropathy. Two 
      thirds of GBS patients are unable to walk at their most severe state of disease. 
      Respiratory insufficiency and autonomic failure are probably the main causes of 
      death. Optimal general care, physiotherapy and the availability of intensive care 
      facilities at short distance are of great importance. Randomized controlled 
      trials show that intravenous immune globulin (IVIg) and plasma exchange (PE) are 
      equally effective in reducing the time to functional recovery. The combination of 
      PE followed by IVIg, is not significantly better than IVIg or PE alone. 
      Corticosteroids alone are not effective in GBS. Approximately 10% of GBS patients 
      deteriorate after initial improvement or stabilization following IVIg or PE 
      treatment, and often require repeated treatment. These "treatment related 
      clinical fluctuations" are more frequently seen in relatively young patients with 
      severe motor and sensory involvement associated with a preceding and possibly 
      ongoing cytomegalovirus infection. Predominantly motor GBS is frequently preceded 
      by a Campylobacter jejeuni infection. Diarrhea prior to GBS is associated with a 
      worse predicted outcome. Further confirmation is needed to determine whether this 
      is especially the case in those patients treated with PE. GBS patients who are 
      unable to walk without assistance, and who are still within their first 2 weeks 
      of the disease, need to be treated. One PE study showed that patients who are 
      only mildly disabled showed positive progress from two plasma exchange sessions. 
      Presently, due to its wide availability, ease of administration, and favorable 
      side-effect profile, IVIg is considered to be the first-line treatment for 
      patients with GBS. Current investigations are trying to determine if IVIg used in 
      combination with methylprednisolone is even more effective in treating GBS.
FAU - van Der Meche FG
AU  - van Der Meche FG
AD  - Department of Neurology, University Hospital Rotterdam, Dr. Molewaterplein 40, GD 
      Rotterdam, 3015, The Netherlands. vandoorn@neur.azr.nl
FAU - van Doorn PA
AU  - van Doorn PA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Treat Options Neurol
JT  - Current treatment options in neurology
JID - 9815940
EDAT- 2000/11/30 00:00
MHDA- 2000/11/30 00:01
CRDT- 2000/11/30 00:00
PHST- 2000/11/30 00:00 [pubmed]
PHST- 2000/11/30 00:01 [medline]
PHST- 2000/11/30 00:00 [entrez]
AID - 10.1007/s11940-000-0029-7 [doi]
PST - ppublish
SO  - Curr Treat Options Neurol. 2000 Nov;2(6):507-516. doi: 10.1007/s11940-000-0029-7.