The refractory period of transmission is impaired in axonal Guillain-Barré syndrome

Satoshi Kuwabara, Hugh Bostock, Kazue Ogawara, Jia Ying Sung, Kazuaki Kanai, Masahiro Mori, Takamichi Hattori, David Burke

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Guillain-Barré syndrome (GBS) is classified as acute motor axonal neuropathy (AMAN) or acute inflammatory demyelinating polyneuropathy (AIDP). Motor nerve conduction block is frequently found in both subtypes of GBS. To compare patterns of conduction block and the safety factor for impulse transmission in AMAN and AIDP, pairs of supramaximal stimuli at intervals of 1-5 ms were delivered to stimulate the median nerve at the wrist. At the 2- and 3-ms intervals, compound muscle action potentials (CMAPs) to the second stimulus were significantly smaller in AMAN patients (n = 7) than in normal subjects (n = 10) and AIDP patients (n = 6). Over 4 weeks from onset, the amplitude of both conditioned and unconditioned CMAPs returned toward normal, consistent with improvement in the safety factor for impulse transmission. The refractory period of transmission is impaired in AMAN, and the site of transmission failure is likely to be the motor nerve terminals. In addition to axonal degeneration, the critically but reversibly reduced safety factor is important in the pathophysiology of AMAN, and consistent with the rapid resolution of distal conduction block often seen in AMAN patients.

Original languageEnglish
Pages (from-to)683-689
Number of pages7
JournalMuscle and Nerve
Volume28
Issue number6
DOIs
Publication statusPublished - Dec 2003
Externally publishedYes

    Fingerprint

Keywords

  • Acute motor axonal neuropathy
  • Guillain-Barré syndrome
  • Refractory period
  • Safety factor
  • Sodium channel

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Kuwabara, S., Bostock, H., Ogawara, K., Sung, J. Y., Kanai, K., Mori, M., Hattori, T., & Burke, D. (2003). The refractory period of transmission is impaired in axonal Guillain-Barré syndrome. Muscle and Nerve, 28(6), 683-689. https://doi.org/10.1002/mus.10488