A case control study of patients with Guillain-Barre syndrome (GBS) in South East England, reported from Guy’s Hospital, London, has uncovered a strong asociation between C jejuni infection and a pure motor GBS, characterized by axonal degeneration either alone or combined with demyelination. C jejuni were isolated from the stools of 4 of 36 (11%) patients compared to 1 of 49 (2%) controls. A strong serological evidence of recent infection was found in an additional 5 patients. Of the total of 9 (25%) infected patients, 8 had a recent history of diarrhea, and 7 (78%) had one or more antibodies to glycoconjugates. [1]
COMMENT. The combination of recent C jejuni infection and positive anti-ganglioside GM1 antibodies heralds a poor prognosis in patients with GBS. The association of antecendent infection with C jejuni and GBS is also reported from the University of Texas Health Science Center, Houston (Vriesendorp FJ et al) and Julius-Maximilians-Universitat, Wurzburg, Germany. [2]
A role for C jejuni infection in the etiology of a Chinese paralytic syndrome (acute motor axonal neuropathy) which resembles GBS has been proposed [3]. This disease shares clinical and CSF findings with the demyelinating GBS, but electrophysiological tests indicate an axonal neuropathy. A febrile illness preceeded muscle weakness in 30% of patients, and some had diarrhea. Outbreaks of the Chinese paralytic syndrome associated with diarrhea and C jejuni infection have also occurred in Japan and Bangladesh. Environmental waterborne infections may have serious neurological complications. (Environmental Food Poisons, PNB Publ).