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IgG Anti-GM1 antibody is associated with reversible conduction failure and axonal degeneration in guillain-barré syndrome

✍ Scribed by Dr. Satoshi Kuwabara; Nobuhiro Yuki; Michiaki Koga; Takamichi Hattori; Daisuke Matsuura; Masami Miyake; Masatoshi Noda

Publisher
John Wiley and Sons
Year
1998
Tongue
English
Weight
649 KB
Volume
44
Category
Article
ISSN
0364-5134

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✦ Synopsis

Abstract

To investigate the pathophysiological role of anti‐GM1 antibody in Gullain‐Barre syndrome (GBS), we reviewed sequential nerve conduction studies of 345 nerves in 34 GBS patients. Statistically significant correlation between IgG anti‐GM1 antibodies and electrodiagnoses was found. Sixteen IgG anti‐GM1‐positive patients were classified as having acute motor sensory axonal neuropathy (AMAN or AMSAN) (12 patients), as having acute inflammatory demyelinating polyneuropathy (AIDP) (3 patientsrpar;, or as undetermined (1 patient) by electrodiagnostic criteria. Besides axonal features, there was rapid resolution of conduction slowing and block. In 3 patients initially diagnosed as having AIDP, conduction slowing was resolved within days, and 1 of them and 3 AMAN patients showed markedly rapid increases in amplitudes of distal compound muscle action potentials that were not accompanied by prolonged duration and polyphasia. The time courses of conduction abnormalities were distinct from those in IgG anti‐GM1‐negative AIDP patients. Rapid resolution of conduction slowing and block, and the absence of remyelinating slow components, suggest that conduction failure may be caused by impaired physiological conduction at the nodes of Ranvier. Reversible conduction failure as well as axonal degeneration constitutes the pathopsiological mechanisms in IgG anti‐GM1)positive GBS. In both cases, immune‐mediated attack probably occurs on the axolemma of motor fibers.

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