PATHOGENESIS OF AXONAL GUILLAIN-BARRE-SYNDROME - HYPOTHESIS

Pathologic studies of acute motor axonal neuropathy show strong eviden ce of the presence of primary axonal Guillain-Barre syndrome (GBS). Th e pathogenesis of axonal GBS is speculated to be as follows: (1) Infec tion by an organism induces the high production of a crossreactive ant ibody between an infectious agent and the motor nerve axon in patients with a particular immunogenetic background. (2) The antineural antibo dy binds to the motor nerve terminals, thereby inhibiting motoneuron e xcitability and causing muscular weakness. (3) Binding of the antineur al antibody, or subsequent functional impairment of the motoneurons, c auses the motor axon to degenerate from the terminals. (4) In severe c ases, extensive axonal loss and central chromatolysis of the motoneuro ns occur. These inhibit recovery and lead to a poor functional prognos is. (C) 1994 John Wiley & Sons, Inc.