THE CLINICALLY PURE MOTOR VARIANT OF GUIL LAIN-BARRE-SYNDROME - REPORT ON 3 CASES

We report three patients with severe Guillain-Barre syndrome (GBS). On clinical examination, no sensory deficit was elicited. Electromyograp hy (EMG) and motor nerve conduction velocity (NCV) studies were indica tive of an axonal lesion. In two patients, we found total peripheral c onduction block without volitional EMG activity, Sensory NCV and corti cal median nerve evoked potentials remained normal, Sural nerve biopsy revealed unequivocal alterations of sensory nerve fibers, some in the form of primary demyelination, Therefore, these cases must bei classi fied as combined motor-sensory syndromes despite the clinical and elec trophysiological findings. Although total denervation of the extremity muscles occurred, causing tetraparalysis, this manifestation appears to be attributable to the secondary axonal variant. In contrast to pos itive reports in literature, immunomodulatory treatment proved ineffec tive in all three cases.