Describe the epidemiology.
Incidence
∼ 1 case per 100,000 individuals
Adults are affected more frequently than children.
Sex: ♂ > ♀ (1.5:1)
Describe causes.
Overview
About ⅔ of GBS patients experience symptoms of an upper respiratory or gastrointestinal tract infection 1–4 weeks prior to onset of GBS. [1]
The causal connection between pathogens and GBS is still undetermined.
Associated pathogens [1][3][4]
Campylobacter jejuni: campylobacter enteritis is the most common disease associated with GBS.
Cytomegalovirus: most common virus associated with GBS
HIV
Influenza
Zika virus
Epstein-Barr virus
SARS-CoV-2
Mycoplasma pneumoniae
Vaccination
There have been reports of small increases in incidence after administration of certain vaccines. [5]
In the US, Guillain-Barré syndrome is listed as vaccination injury for the seasonal influenza vaccines.
Describe the pathophysiology.
Postinfectious autoimmune reaction that generates cross-reactive antibodies (molecular mimicry)
Infection triggers humoral response → formation of autoantibodies against gangliosides (e.g., GM1, GD1a) or other unknown antigens of peripheral Schwann cells → immune-mediated segmental demyelination → axonal degeneration of motor and sensory fibers in peripheral and cranial nerves (CN III–XII)
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