To analyze the incidence of axonal vs demyelinating Guillain-Barré Syndrome (GBS) subtypes presenting to an academic center.

GBS is an autoimmune disease caused by molecular mimicry, where pathogenic epitopes from an infection are similar or identical to nerve antigens, resulting in autoimmune injury like axonal degeneration and demyelination. The classic GBS subtype is acute inflammatory demyelinating polyneuropathy (AIDP), however, acute motor sensory axonal neuropathy (AMSAN) and acute motor axonal neuropathy (AMAN) have been well described.

In a retrospective analysis of all cases of GBS identified in a database search of our electronic medical record system, we collected a list of subjects. The cases were verified by inclusion criteria of at least 2 of the following: supportive findings on electromyography, albuminocytologic dissociation on cerebrospinal fluid, clinical criteria, positive antibodies, or responsive to treatment. It was hypothesized that the AIDP subtype would be more common than AMSAN or AMAN. Information from the workup, diagnosis, course, and treatment were analyzed.

45 cases of GBS (m:23, f:22) from 2006 - 2019 were identified. Age ranged from 19 to 86 years (M=57.3, SD=18.4), average length of hospitalization was 13 days, and 28.9% and 22.2% had preceding symptoms for respiratory and gastrointestinal infections, respectively. The most common presenting symptom was lower extremity weakness (91.1%), followed by upper extremity paresthesia (55.6%). Physical exam was most notable for lower extremity weakness (80%) and hyporeflexia or areflexia (82.2%). The most common GBS subtype was AIDP (55.6%), followed by AMSAN (26.7%), and AMAN (8.9%). 80% of patients received intravenous immunoglobulin therapy, 11.1% received plasmapheresis and 8.9% received both. There were no significant findings between sex, age, or GBS subtype with the variables in the study.

The most common subtype of GBS was AIDP, although the non-demyelinating forms were fairly common. There were no significant differences in clinical course among the subtypes.