Classic Guillain-Barré syndrome

Classic Guillain-Barré syndrome is an acute, post-infectious, immune-mediated polyneuropathy with a variable degree of flaccid tetraparesis. It includes demyelinating and axonal forms. Numerous nosological advances are reviewed, largely driven by the IGOS Consortium (International Guillain-Barré Outcome Study) after having compiled 2000 patients from multiple nationalities including Spanish, which has made it possible to promote scales that facilitate its diagnosis and prognosis. Special emphasis has been placed on the pathological substrate of autopsy, and particularly in the very early phase of the syndrome (≤4days after onset), when the fundamental lesion is inflammatory edema of proximal nerve trunks and particularly of spinal nerves. This notion opens new pathogenic, diagnostic and therapeutic perspectives, helping to better understand why serum axonal biomarkers of axonal damage are elevated, in both axonal and demyelinating forms.