History of Guillain-Barré syndrome

J. Berciano
Neurosciences and History 2022;10(2):61-91

Type of article: REVIEW

AUTHOR

J. Berciano
Emeritus professor ad honorem. Universidad de Cantabria, Santander, Spain. Former head of the Department of Neurology. Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain. Biomedical Research Network on Neurodegenerative Diseases (CIBERNED), Madrid, Spain.

ABSTRACT

Introduction. Guillain-Barré syndrome (GBS) is an acute, postinfectious, immune-mediated polyneuropathy. It is classified into three basic forms: 1) acute inflammatory demyelinating polyneuropathy (AIDP); 2) axonal GBS, including acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN); and 3) Miller-Fisher syndrome, which presents with the triad of ophthalmoplegia, ataxia, and areflexia. Clinically, GBS is subdivided into classical (with a variable degree of flaccid tetraparesis; AIDP, AMAN, and AMSAN) and localised forms (eg, pharyngeal-cervical-brachial variant of GBS).

Objective. This study presents a historical review of the classical forms of GBS.

Development. By chronological order of publication, the article is organised into the following sections: 1) original descriptions of classical GBS and two related entities; 2) critical review of the complex histopathological substrate of GBS and the determinants of its dynamic variability; 3) contribution to diagnosis of neurophysiological, imaging, and biological testing; 4) epidemiological, prognostic, and therapeutic aspects; and 5) two final discussions on the overarching pathophysiological role of Ia afferent fibre dysfunction in early areflexia and on the nosological classification of the acute paralytic syndrome of the American president Franklin Delano Roosevelt.

Conclusion. This historical exploration of the nosology of classical GBS demonstrates the great advances in our understanding of this entity, although several matters remain controversial.

KEYWORDS

Ia afferents, corticosteroids, axonal degeneration, demyelination, endoneurial inflammatory oedema, Franklin Delano Roosevelt, spinal nerve, experimental autoimmune neuritis, Landry ascending paralysis, acute flaccid paresis, Guillain-Barré syndrome

Neurosciences and History 2022;10(2):61-91