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Neuromuscular transmission is not impaired in axonal Guillain--Barré syndrome
Satoshi Kuwabara1, N Kokubun, S Misawa
1Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. kuwabara-s@faculty.chiba-u.jp
Background:
Previous studies have shown that anti-GQ1b antibodies induce massive neuromuscular blocking. If anti-GM1 and -GD1a antibodies have similar effects on the neuromuscular junction (NMJ) in human limb muscles, this may explain selective motor involvement in axonal Guillain--Barré syndrome (GBS).
Methods:
Axonal-stimulating single-fibre electromyography was performed in the extensor digitorum communis muscle of 23 patients with GBS, including 13 with the axonal form whose sera had a high titre of serum IgG anti-GM1 or -GD1a antibodies.
Results:
All patients with axonal or demyelinating GBS showed normal or near-normal jitter, and no blocking.
Conclusion:
In both axonal and demyelinating GBS, neuromuscular transmission is not impaired. Our results failed to support the hypothesis that anti-GM1 or -GD1a antibody affects the NMJ. In GBS, impulse transmission is presumably impaired in the motor nerve terminal axons proximal to the NMJ.
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