To identify subclinical autonomic dysfunction in mild Guillain-Barré syndrome (GBS), a set of autonomic function tests was serially performed for up to 6 months in 5 GBS patients with mild disability at the nadir. Parasympathetic autonomic function tests consisted of Valsalva ratio and R-R interval variation during rest and deep breathing. Sympathetic autonomic function was evaluated by blood pressure responses to sustained handgrip, hand immersion in ice water, and active standing. The results showed that abnormal parasympathetic and sympathetic function was frequently encountered in all 5 patients during the acute stage of the illness. Autonomic dysfunction occurred both in axonal and demyelinating types of GBS. There was a trend of improvement in most autonomic function tests after 3 months, comparable to the recovery of motor function. In conclusion, subclinical autonomic dysfunction was present in mild GBS. It was temporary and would resolve spontaneously.

1.
Arnason BGW, Soliven B: Acute inflammatory demyelinating polyradiculoneuropathy; in Dyck PJ, Thomas PK, Griffin JW, Low PA, Poduslo JF (eds): Peripheral Neuropathy, ed 3. Philadelphia, Saunders, 1993, vol 2, pp 1437–1497.
2.
Ropper AH: The Guillain-Barré syndrome. N Engl J Med 1992;326:1130–1136.
3.
de Jager AEJ, Sluiter HJ: Clinical signs in severe Guillain-Barré syndrome: Analysis of 63 patients. J Neurol Sci 1991;104:143–150.
4.
Tuck RR, McLeod JG: Autonomic dysfunction in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 1981;44:983–990.
5.
Singh NK, Jaiswal AK, Misra S, Srivastava PK: Assessment of autonomic dysfunction in Guillain-Barré syndrome and its prognostic implications. Acta Neurol Scand 1987;75:101–105.
6.
Zochodne DW: Autonomic involvement in Guillain-Barré syndrome: A review. Muscle Nerve 1994;17:1145–1155.
7.
Ropper AH: Intensive care of acute Guillain-Barré syndrome. Can J Neurol Sci 1994;21(suppl):23–27.
8.
Hund EF, Borel CO, Cornblath DR, Hanley DF, McKhann GM: Intensive management and treatment of severe Guillain-Barré syndrome. Crit Care Med 1993;21:433–446.
9.
Flachenecker P, Wermuth P, Hartung H-P, Reiners K: Quantitative assessment of cardiovascular autonomic function in Guillain-Barré syndrome. Ann Neurol 1997;42:171–179.
10.
Truax BT: Autonomic disturbances in the Guillain-Barré syndrome. Semin Neurol 1984;4:462–468.
11.
Halls J, Bredkjær C, Friis ML: Guillain-Barré syndrome: Diagnostic criteria, epidemiology, clinical course and prognosis. Acta Neurol Scand 1988;78:118–122.
12.
Lyu RK, Tang LM, Cheng SY, Hsu WC, Chen ST: Guillain-Barré syndrome in Taiwan: A clinical study of 167 patients. J Neurol Neurosurg Psychiatry 1997;63:494–500.
13.
Bansal BC, Sood AK, Jain SK: Dysautonomia in Guillain Barré syndrome. J Assoc Physicians India 1987;35:417–419.
14.
Persson A, Solders G: R-R variations in Guillain-Barré syndrome: A test of autonomic dysfunction. Acta Neurol Scand 1983;67:294–300.
15.
Asbury AK, Cornblath DR: Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 1990;27(suppl):21–24.
16.
Hughes RAC, Newsom-Davis JM, Perkin GD, Pierce JM: Controlled trial of prednisolone in acute polyneuropathy. Lancet 1978;ii:750–753.
17.
Wieling W, Karemaker JM: Measurement of heart rate and blood pressure to evaluate disturbances in neurocardiovascular control; in Mathias CJ, Bannister R (eds): Autonomic Failure. A Textbook of Clinical Disorders of the Autonomic Nervous System, ed 4. Oxford, Oxford University Press, 1999, pp 196–210.
18.
Shahani BT, Day TJ, Cros D, Khalil N, Kneebone CS: RR interval variation and the sympathetic skin response in the assessment of autonomic function in peripheral neuropathy. Arch Neurol 1990;47:659–664.
19.
Kihara M, Nakashima H, Takahashi M, Kawamura Y: A dysautonomia case of Guillain-Barré syndrome with recovery: Monitored by composite autonomic scoring scale. J Auton Nerv Syst 1998;73:186–189.
20.
Ropper AH, Wijdicks EFM, Truax BT: Guillain-Barré Syndrome. Philadelphia, Davis, 1991.
21.
Feasby TE, Gilbert JJ, Brown WF, Bolton CF, Hahn AF, Koopman WF, Zochodne DW: An acute axonal form of Guillain-Barré polyneuropathy. Brain 1986;109:1115–1126.
22.
Reisin RC, Cersósimo R, Alvarez MG, Massaro M, Fejerman N: Acute ‘axonal’ Guillain-Barré syndrome in childhood. Muscle Nerve 1993;16:1310–1316.
23.
Visser LH, van der Meché FGA, van Doorn PA, Meulstee J, Jacobs BC, Oomes PG, Kleyweg RP and the Dutch Guillain-Barré Study Group: Guillain-Barré syndrome without sensory loss (acute motor neuropathy): A subgroup with specific clinical, electrodiagnostic and laboratory features. Brain 1995;118:841–847.
24.
Ravits JM: AAEM minimonograph#48: Autonomic nervous system testing. Muscle Nerve 1997;20:919–937.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.