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Variants and differential diagnosis of Guillain-Barré syndrome.

Guillain-Barré syndrome is characterized by acute progressive weakness, areflexia and maximal motor disability that occur within 4 weeks of onset. Its clinical and pathological spectra range extends from classical acute inflammatory demyelinating polyneuropathy to axonal variants with (acute motor sensory axonal neuropathy) or without (acute motor axonal neuropathy) sensory involvement. Moreover, several clinical variants (Fisher syndrome, ataxic Guillain-Barré syndrome and pharyngeal-cervical-brachial weakness) have been proposed. The association of clinical characteristics of Guillain-Barré syndrome with specific infections and the presence of antiganglioside antibodies also has been reported. Guillain-Barré syndrome now is recognized as a heterogeneous disorder with various clinical manifestations and recent neurophysiological and pathological findings have led to its reclassification. This review summarizes current concepts about the clinical spectrum of Guillain-Barré syndrome and its variants and about differential diagnosis.