Neuromuscular transmission is not impaired in axonal Guillain-Barre syndrome

作者：Kuwabara S^*; Kokubun N; Misawa S; Kanai K; Isose S; Shibuya K; Noto Y; Mori M; Sekiguchi Y; Nasu S; Fujimaki Y; Hirata K; Yuki N

来源：Journal of Neurology Neurosurgery and Psychiatry, 2011, 82(10): 1174-1177.

DOI：10.1136/jnnp.2010.210708

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-Barre 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.

• 出版日期2011-10