PLASMA-EXCHANGE IN THE GUILLAIN-BARRE-SYN DROME - IN SEARCH OF NEW THERAPEUTIC STRATEGY

Although the favorable effect of plasma exchange (PE) has been demonst rated in Guillain-Barre syndrome, the optimal number of PE and managem ent at different degrees of gravity remain to be ascertained. A new co ntrolled multicentric trial is therefore being conducted since 1986. M id-term results show that 2 PE give better results than 0 in patients who are still able to walk. Inversely, 6 PE do not give better results when ventilatory assistance was initially required. It is therefore l ogical to propose 2 PE as early as possible. Two supplementary PE can be used in case of disease progression. Use of high dose immunoglobuli ns is not justified except when PE is contraindicated.