2025 Volume 36 Issue 1 Pages 60-66
Guillain-Barré syndrome ( GBS ) typically present with generalized-symmetrical limb weakness and areflexia, but some cases show asymmetric or multifocal muscle weakness in acute phase. There have been no reports examining a large number of GBS with asymmetric/multifocal weakness in acute phase ( A/M-GBS ) , and the exact incidence and clinical characteristics are unknown. We reviewed the literature on A/M-GBS and examined the clinical features of A/M-GBS. Previous reports have shown that cases of axonal type GBS tend to present with asymmetrical symptoms. Our study with large number ( n=209 ) of GBS showed that the frequency of A/M-GBS was higher than previously reported ( 11% ) . Compared with typical GBS, A/M-GBS had a significantly higher proportion with prior infection, more elderly male cases and more cases positive for anti-glycolipid antibodies. A significantly higher proportion of A/M-GBS sera were positive for AMAN-associated anti-glycolipid antibodies. There was no difference in the severity of symptoms at peak between A/M-GBS and typical GBS cases, indicating the importance of diagnosing A/M-GBS early and initiating appropriate treatment.
