Since the eradication of poliomyelitis in the western hemisphere, Guil
lain-Barre syndrome (GBS) has become the most common cause of acute ne
uromuscular paralysis in the developed world. GBS is an acute disease
of peripheral nerves that is characterized by the stripping away of my
elin in a segmental fashion, resulting in rapidly ascending paralysis
that can lead to respiratory muscle compromise and death. It has long
been recognized that frequently, GBS is preceded hy an acute infectiou
s illness. Indeed, the renowned late 19th- and early 20th-century phys
ician, Sir William Osler, called the syndrome ''acute post-infectious
polyneuritis'' in 1892.(57) Evidence is mounting, however, that the mo
st important trigger of GBS is not vaccines or viruses but infection w
ith the common diarrhea-producing bacteria, Campylobacter jejuni. This
article reviews the evidence that Campylobacter infections may cause
GBS and discusses the pathogenesis of Campylobacter-induced GBS.