This usually produces weakness of the extremities and axial musculature, which can evolve to respiratory motor failure and asphyxiation if support is not available.Prior to availability of artificial respiratory support, the mortality rate was 60%.Also, CSF shows very high protein (often higher than with GBS) with few actual inflammatory cells.Multiple sclerosis has been defined as "multiple white matter lesions separated in space and time".
The more severe the symptoms and the older the patient, the more likely there is to be residual damage.Involvement of the autonomic nervous system also may occur indicating an axonal involvement and, indeed, there is a form of GBS in which axonal involvement predominates (particularly in the Eastern Asia). Partnervermittlung katholische partnersuche Autonomic involvement may lead to threatening blood pressure irregularities and cardiac arrhythmias.A prior, usually upper respiratory, infection with one of a variety of agents was the original reason for implicating an immune mechanism.More recently, it has been recognized that preceding diarrheal illness due to campylobacter infection can also trigger it.
This condition is due to a chronic immune attack on the peripheral myelin.It is usually more insidious than Guillain-Barre syndrome and it also responds better to immune modulating treatments.As the condition progresses, there can be sensory change, as well (usually numbness and tingling), but the picture is usually dominated by flaccid weakness.Although the most common presentation is with an ascending paralysis, rarely, it can begin by affecting cranial muscles.In this condition, peripheral nerves (actually, usually at the level of the proximal nerve roots) show inflammatory infiltrates with cells involved in cell-mediated immunity.
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Because cell mediated immunity is involved, the condition appears to depend more on local cytokine production than the development of circulating antibodies.
Diagnosis can be aided by CSF evaluation, which shows high protein levels, with very few actual inflammatory cells (usually not above the upper limit of normal).
This has been termed "cytoalbuminologic dissociation." There is an experimental model for this condition (experimental allergic neuritis).
There is usually relatively little damage to underlying axons unless the inflammatory reaction is dramatic.
GBS is a dramatic acute demyelinating neuropathy with rapid onset (hours to days).