AXONAL GUILLAIN-BARRE-SYNDROME

The issue of ''axonal'' Guillain-Barre syndrome (GBS) remains controve rsial. Supportive evidence comes from pathological examination of peri pheral nerves in 4 extreme cases of GBS 17-29 days after onset which s howed severe axonal degeneration without inflammatory-demyelination. I t has been suggested that inflammatory-demyelination may have been mis sed. This is difficult to disprove but it seems unlikely, given the kn own correlation between the severity of axonal degeneration and inflam mation/demyelination in the experimental model of GBS, experimental al lergic neuritis (EAN). Electrically inexcitable nerves in GBS may refl ect axonal degeneration, terminal demyelination or both. This finding proved to be a sign of poor prognosis in 19 of 27 (70%) patients, alth ough a good outcome occurred in some cases. (C) 1994 John Wiley & Sons , Inc.