What is the classification of Guillain-Barré Syndrome (GBS)?

From the Guidelines

Guillain-Barré syndrome (GBS) is primarily classified into four main types: Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN), and Miller Fisher Syndrome (MFS). The classification of GBS is based on clinical and electrophysiological features, as described in a study published in Nature Reviews Neurology in 2019 1.

Key Characteristics of Each Type

• AIDP: characterized by demyelination of peripheral nerves, accounts for about 90% of cases in North America and Europe
• AMAN: primarily affects motor nerves, more common in Asia and Central and South America
• AMSAN: a severe form that affects both motor and sensory nerves
• MFS: characterized by ophthalmoplegia, ataxia, and areflexia This classification is crucial for determining the most appropriate treatment approach and predicting the course of the disease, as different types of GBS may respond differently to treatment, with AIDP typically responding well to immunotherapy, while axonal forms may have a slower recovery 1.

Importance of Classification

Recognizing the specific type of GBS can help clinicians tailor their treatment strategies and provide more accurate prognosis information to patients. Electrophysiological studies, such as those mentioned in the 2019 study 1, provide evidence of PNS dysfunction and can distinguish between the subtypes of GBS. By understanding the classification of GBS, clinicians can improve patient outcomes and reduce morbidity and mortality associated with the disease.

From the Research

Classification of Guillain-Barré Syndrome (GBS)

The classification of Guillain-Barré Syndrome (GBS) can be broken down into several subtypes, including:

• Acute inflammatory demyelinating polyneuropathy (AIDP) 2, 3, 4, 5, 6
• Acute motor axonal neuropathy (AMAN) 2, 3, 4, 5, 6
• Acute motor and sensory axonal neuropathy (AMSAN) 4, 5, 6
• Miller-Fisher syndrome (MFS) 3, 5
• Minor abnormalities pattern 2

Subclassification of AIDP

AIDP can be further subclassified into:

• Motor-sensory AIDP (MS-AIDP) 2
• Motor AIDP (M-AIDP) 2

Clinical Variants

GBS can also present with various clinical variants, including:

• Cranial nerve variant with ophthalmoplegia, ataxia, and areflexia 4
• Pure sensory neuropathy/neuronopathy 5
• Pandysautonomia 5
• Oropharyngeal variant 5
• GBS-MFS overlap 3

Pathophysiological Classification

GBS can be pathophysiologically classified into:

• Complement-mediated nerve injury caused by antibody-antigen interaction in the peripheral nerves 6
• Nodal dysfunction induced by the immune response in nodal axolemma, termed "nodopathy" 6