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J Neurol Neurosurg Psychiatry. 2011 Jan 26. [Epub ahead of print]

Guillain-Barre syndrome subtypes related to Campylobacter infection.

Drenthen J, Yuki N, Meulstee J, Maathuis EM, van Doorn PA, Visser GH, Blok JH, Jacobs BC.

Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.

Abstract

Background In Guillain-Barr syndrome (GBS), the diversity in electrophysiological subtypes is unexplained but may be determined by geographical factors and preceding infections. Acute motor axonal neuropathy (AMAN) is a frequent GBS variant in Japan and one study proposed that in Japan, Campylobacter jejuni infections exclusively elicit AMAN. In The Netherlands C jejuni is the predominant type of preceding infection yet AMAN is rare. This may indicate that not all Dutch GBS patients with C jejuni infections have AMAN. Objective To determine if GBS patients with a preceding C jejuni infection in The Netherlands exclusively have AMAN. Methods Retrospective analysis of preceding infections in relation to serial electrophysiology and clinical data from 123 GBS patients. C jejuni related cases were defined as having preceding diarrhoea and positive C jejuni serology. Electrophysiological characteristics in C jejuni related cases were compared with those in viral related GBS patients. In addition, eight GBS patients from another cohort with positive stool cultures for C jejuni were analysed. Results 17 (14%) of 123 patients had C jejuni related GBS. C jejuni patients had lower motor and higher sensory action potentials compared with viral related cases. Nine (53%) C jejuni patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the criteria for acute inflammatory demyelinating polyneuropathy (AIDP). Also, two (25%) of eight additional patients with a C jejuni positive stool sample had AIDP. Conclusion In The Netherlands, C jejuni infections are strongly, but not exclusively, associated with axonal GBS. Some patients with these infections fulfil current criteria for demyelination.

PMID: 21270063 [PubMed - as supplied by publisher]

 

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