[Autonomic Dysfunction in Guillain-Barré Syndrome]

Guillain-Barré syndrome is an acute-onset, immune-mediated neuropathy characterized by humoral immune attacks on peripheral motor and sensory nerve fibers, with predominant motor involvement. Autonomic dysfunction, typically characterized by sympathetic hyperactivity, is common and varies in severity, occasionally affecting prognosis. This autonomic dysfunction is considered to result from conduction failure in autonomic nerve fibers, similar to the damage observed in motor and sensory fibers. It remains unclear whether this process results from an immune response against common antigens expressed on motor, sensory, and autonomic nerves or from an immune reaction against antigens specific to the autonomic nervous system that occurs concurrently with attacks on motor and sensory nerves. This paper summarizes the clinical semiology and pathological and physiological findings of autonomic dysfunction in Guillain-Barré syndrome and discusses its pathophysiology by comparing it with other immune-mediated autonomic neuropathies.