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Gregory Gruener, MD; E. Peter Bosch, MD; Ronald G. Strauss, MD; Marie Klugman, PhD; Jun Kimura, MD

Arch Neurol. 1987;44(3):295-298.

Abstract
• We attempted to identify predictive factors of early beneficial response to plasmapheresis in Guillain-Barré syndrome (GBS). We reviewed 24 patients with typical severe GBS who underwent plasmapheresis and analyzed their outcome at one month. One group of 14 patients, designated as responders, improved dramatically, while ten patients showed little response. Age was the only important clinical predictor, with responders being younger. No other clinical variable (sex, preceding illness, severity, timing of plasmapheresis, cranial nerve involvement, or cerebrospinal fluid findings) reached significance. Among electrophysiologic parameters obtained before plasmapheresis, the amplitudes of compound muscle action potentials with distal stimulation of median and peroneal nerves were significantly reduced in nonresponders. Plasmapheresis may improve only a subgroup of patients with GBS. Among patient characteristics, age and amplitudes of compound muscle action potentials are important predictors of early responsiveness.

Author Affiliations
From the Departments of Neurology (Drs Gruener, Bosch, and Kimura), Pathology (Dr Strauss), and Preventive Medicine (Dr Klugman), University of Iowa College of Medicine, Iowa City. Dr Gruener is now with the University of Illinois, Chicago.

Footnotes
Accepted for publication Oct 13, 1986.

Presented at the Second International Meeting of the Peripheral Neuropathy Association of America, Hilton Head Island, SC, Nov 8, 1986.

Reprint requests to Department of Neurology, University of Iowa Hospitals, Iowa City, IA 52242 (Dr Bosch).

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