• V T Carpentier, L Le Guennec, S A A Fall, K Viala, S Demeret, and N Weiss.
• Service de médecine Physique et de Réadaptation, Garches, AP-HP, Université Paris Saclay, Hôpital Raymond Poincaré, Paris, France; U1179 END-ICAP, Inserm, UFR Simone Veil-Santé, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris Saclay, Montigny-le-Bretonneux, France; ISPC Synergies, Paris, France; Groupe de recherche en neuro-orthopédie de Garches (GRENOG), Garches, France.
• Rev Med Interne. 2022 Jul 1; 43 (7): 419-428.

AbstractGuillain-Barré syndrome (GBS) is the most common cause of acute neuropathy. It usually onset with a rapidly progressive ascending bilateral weakness with sensory disturbances, and patients may require intensive treatment and close monitoring as about 30% have a respiratory muscle weakness and about 10% have autonomic dysfunction. The diagnosis of GBS is based on clinical history and examination. Complementary examinations are performed to rule out a differential diagnosis and to secondarily confirm the diagnosis. GBS is usually preceded by an infectious event in ≈ 2/3 of cases. Infection leads to an immune response directed against carbohydrate antigens located on the infectious agent and the formation of anti-ganglioside antibodies. By molecular mimicry, these antibodies can target structurally similar carbohydrates found on host's nerves. Their binding results in nerve conduction failure or/and demyelination which can lead to axonal loss. Some anti-ganglioside antibodies are associated with particular variants of GBS: the Miller-Fisher syndrome, facial diplegia and paresthesias, the pharyngo-cervico-brachial variant, the paraparetic variant, and the Bickerstaff brainstem encephalitis. Their semiological differences might be explained by a distinct expression of gangliosides among nerves. The aim of this review is to present pathophysiological aspects and the diagnostic approach of GBS and its variants.Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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