Variability of the Course of the Guillain‐Barre Syndrome

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Abstract
The accumulating literature would suggest that the Guillain-Barre syndrome is only a symptom-complex in the course of many diseases, chiefly viral. The reaction at the point of junction of the anterior and posterior roots causes blockage and stagnation of the cerebrospinal fluid. The increased protein is believed to be due to the increased permeability of the dilated radicular and spinal meningeal vessels. The course of the symptom-complex has been inadequately understood. Four cases are reported showing variable courses (a) rapid development and resolution, (b) progressive development with gradual recovery with residue, (c) relapsing course with rapid progression and regression, and (d) concomitant recovery and progression. Certainly the syndrome varies both as to course and involvement, and there is no way of projecting the future even when apparent recovery has set in It would appear that re-exposure to the original may cause a resurgence of symptoms as suspected in 2 cases. The question of previous disease as the sensitizing factor is also suggested in the various studies. The course and prognosis therefore depends on etiology. Ultimately, the now unknown may so whittle down until the entire syndrome will be absorbed into established diseases.