[Guillain-Barre syndrome. Current treatment principles in the light of clinical aspects]

The Guillain-Barré's syndrome, or acute polyradiculoneuropathy, is a monophasic neurological disease affecting 50-100 persons a year in Norway. In addition to peripheral paresis, respiratory and autonomic disturbances may occur. We present 22 patients, mean age 34.8 years, including four children between four and six years of age, who all received plasma exchange treatment. All our patients reported symptoms of a modest infection average 19 days before the neurological symptoms appeared. All patients had walking difficulties, half of them were unable to walk without assistance. There were cranial nerve findings in 18 patients, and nine had autonomic disturbances when admitted. All except one had increased protein contents in the spinal fluid as well as pathological findings in electrophysiological investigations. They received on average 8.6 plasma exchanges. In spite of such treatment, the total mortality rate has not decreased substantially. Two of our patients died, and three developed severe permanent paresis. Further studies on pathogenesis will be required to increase treatment success.