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Neuromuscular transmission is not impaired in axonal Guillain-Barre syndrome.

by S Kuwabara, N Kokubun, S Misawa, K Kanai, S Isose, K Shibuya, Y Noto, M Mori, Y Sekiguchi, S Nasu, Y Fujimaki, K Hirata, N Yuki show all authors
Journal of Neurology, Neurosurgery & Psychiatry (2011)

Abstract

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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