Landry-Guillain-Barré-Strohl. Polyneuritis

Peripheral neuropathy associated with dietary riboflavin deficiency in the chicken. I. Light microscopic study

Chickens fed a riboflavin-deficient diet from hatching had leg weakness and paralysis as early as 12 days of age. Signs worsened through day 16; after 35 days, recovery was evident. Sciatic nerves from affected chickens were enlarged. Significant microscopic lesions were confined to peripheral nerves and included tissue separation (suggesting interstitial edema), Schwann cell swelling, perivascular leukocytic infiltration, and segmental demyelination accompanied by accumulation of osmiophilic debris in Schwann cell cytoplasm. Axon degeneration was present, but was not a primary lesion. Acid phosphatase enzyme activity of Schwann cells was increased in affected nerves. These results demonstrate that dietary riboflavin deficiency causes a demyelinating peripheral neuropathy in young, rapidly growing chickens.

Failure of oral versus parenteral corticosteroids in a case of acute inflammatory polyradiculoneuropathy (Guillain-Barré syndrome)

A case of acute inflammatory polyradioculoneuropathy (IPN, Guillain-Barré syndrome) not responding to oral corticosteroids but showing marked improvement on parenteral corticosteroids is reported. Oral prednisone 60 mg/day was begun on hospital admission and increased after one week to 100 mg/day; however, the patient's respiratory function, demonstrated by forced vital capacity, continued to deteriorate. Improvement was noted when the patient was switched to intravenous methyl-prednisolone 100 mg/day. Further attempts to use oral corticosteroids (including oral methyl-prednisolone 96 mg/day) resulted in deterioration of the patient's function.

The Guillain-Barré syndrome in intensive care

The history, clinical presentation and pathological findings of the Guillain-Barré Syndrome are presented. An analysis is made of patients with this syndrome admitted to an intensive care ward over a six year period. Results and management are discussed.