[Acute relapsing Guillain-Barré syndrome after 5 and 7 years asymptomatic intervals]

A 26-year-old man who recovered from an initial episode of Guillain-Barré syndrome had two relapses after 5 years and then again after 7 years of asymptomatic intervals. The antecedent illnesses, distribution of weakness and clinical courses of each relapse were similar to each other, and each episode reached its peak within 10 days. He received different types of therapy on each time; gammaglobulin and steroid treatment, steroid monotherapy and plasma exchanges. Plasma exchanges were thought to be the most effective. Serum testing by enzyme-linked immunosorbent assay revealed that the patient contained high titer of IgG antibodies against GD1a and GT1b gangliosides and low titer of those against GM1 and GD1b, which were reduced during his clinical improvement.