SEVERE CASES OF GUILLAIN-BARRE-SYNDROME

The Guillain-Barre syndrome (GBS-acute idiopathic polyneuritis) is characterized by a symmetrically ascending tetraparesis with areflexia associated with sensory deficits, involvement of cranial nerves and impairment of the autonomous nervous system. Within the last 8 years 15 patients with GBS had to be taken to the intensive care unit because of imminent insufficiency of the respiratory and circulatory systems. Involvement of the autonomous nervous system with tachycardia and dysregulation of blood pressure was suspected in 3 cases. The triad ophthalmoplegia, ataxia and areflexia (Fisher's syndrome) was found in 7 patients and was associated with respiratory insufficiency in 4 cases. 8 cases were treated with steroids and/or plasmapheresis. 6 patients required artificial ventilation (4 patients for an average duration of 28 days, 2 for 138 days). On discharge only 2 patients were depending on a wheelchair or a walking aid.