Full Description
This specialized book is devoted solely to the subject of Guillain-Barre syndrome and inflammatory neuropathies. It describes the pathogenesis, clinical features, neurophysiology and treatment of Guillain-Barre syndrome, an acute paralyzing disorder usually due to inflammation and demyelination in the spinal roots and peripheral nerves. In clinical practice, the syndrome is an important cause of neuromuscular paralysis requiring artificial ventilation. The pathogenesis is interpreted in the light of experimental models of inflammatory neuropathy induced by antibody or T lymphocyte responses directed against myelin or purified myelin antigens. These autoimmune responses are triggered by infections with viruses, including the virus which causes AIDS. The pathology and immunology of Guillain-Barre syndrome are compared with chronic idiopathic demyelinating polyradiculoneuropathy and inflammatory human neuropathies, such as in vasculitis and leprosy, as well as veterinary conditions such as Marek's Disease.
Contents
1 History and Definition.- Landry's Acute Ascending Paralysis.- Acute Febrile Polyneuritis.- Acute Infective Polyneuritis.- A Syndrome of Radiculoneuritis with Albumino-cytological Dissociation.- Guillain-Barre Syndrome or Landry's Ascending Paralysis.- Chronic Idiopathic Demyelinating Polyradiculoneuropathy.- Guillain-Barre Syndrome in History and the News.- Summary.- References.- 2 Immunobiology of the Peripheral Nervous System.- Wallerian Degeneration Versus Primary Demyelination.- Myelin.- Blood-Nerve Barrier.- Antigen Presentation in the Peripheral Nervous System.- Final Common Pathway of Immunologically Mediated Demyelination.- Antibody-Mediated Demyelination.- Antibody-Dependent Cell-Mediated Demyelination.- Cell-Mediated Cytotoxicity Causing Demyelination.- Delayed Hypersensitivity to Myelin Antigens Causing Demyelination.- Bystander Demyelination.- Summary.- References.- 3 Experimental Allergic Neuritis.- Experimental Allergic Encephalomyelitis.- Pathology of EAN.- Neurological Signs of EAN.- Experimental Autonomic Neuropathy.- Chronic Relapsing Experimental Allergic Neuritis.- Neurophysiology.- Cerebrospinal Fluid.- Identification of the Antigen Responsible for EAN.- Genetic Factors.- Antibody Production in EAN.- Cell-Mediated Immunity in EAN.- Galactocerebroside Neuritis.- Treatment of EAN.- Summary.- References.- 4 Pathology of Guillain-Barre Syndrome.- Autopsy Observations of Guillain-Barre Syndrome.- Biopsy Studies in Guillain-Barre Syndrome.- Immunohistochemical Studies of Nerves in GBS.- Remyelination.- Summary.- References.- 5 Epidemiology.- Swine Influenza Vaccine Epidemic.- Post-Rabies Vaccine Neuritis.- Viral Infections as Antecedent Events.- Mycoplasma, Bacterial and Other Infections as Antecedent Events.- Other Possible Precipitants of GBS.- Summary.- References.- 6 Clinical Features of Guillain-Barre Syndrome.- Presentation.- Clinical Course.- Differential Diagnosis.- Miller Fisher Syndrome.- Autonomic Dysfunction.- Papilloedema.- Other Complications.- Summary.- References.- 7 Clinical Neurophysiology.- Frequency of Abnormalities of Motor Nerve Conduction.- Time Course of Nerve Conduction Abnormalities.- Sensory Nerve Conduction.- Axonal Degeneration in GBS.- Myokymia in GBS.- Evoked Potentials.- Electrophysiological Evidence and Prediction of Prognosis.- Mechanisms.- Summary.- References.- 8 Treatment of Guillain-Barre Syndrome.- Prognosis.- General Care.- Steroids.- Plasma Exchange.- Intravenous Immunoglobulin.- Immunosuppressive Drugs.- Rehabilitation.- Summary.- References.- 9 Immunology of Guillain-Barre Syndrome.- Cerebrospinal Fluid.- Diseases Associated with Guillain-Barre Syndrome.- HLA Associations.- Immunoglobulins, Complement and Immune Complexes.- Complexes.- Antibodies.- Cellular Immunity.- Summary.- References.- 10 Chronic Idiopathic Demyelinating Polyradiculoneuropathy.- Diagnostic Criteria.- Preceding Events.- Clinical Features.- Differential Diagnosis.- Evidence for CNS Involvement in CIDP.- Neurophysiology.- Cerebrospinal Fluid.- Pathology.- Immunology.- Treatment.- Summary.- References.- 11 Animal Models of Guillain-Barre Syndrome.- Marek's Disease.- Coonhound Paralysis.- Animal Idiopathic Polyradiculoneuropathy.- Cauda Equina Neuritis of the Horse.- Summary.- References.- 12 Other Inflammatory or Demyelinating Neuropathies.- Vasculitic Neuropathy.- Sarcoid Neuropathy.- Plasma Cell Dyscrasias and Neuropathy.- Leprosy.- Human Immunodeficiency Virus Infection and Neuropathy.- Summary.- References.- Appendix. Guillain-Barre Syndrome: A Short Guide for the Patient, Relative and Friend.
