Afifi A K
Professor, Department of Pediatrics, College of Medicine, University of Iowa, USA.
J Family Community Med. 1994 Jan;1(1):30-4.
The history of the development of knowledge about Guillain-Barré-Syndrome (GBS) is reviewed. The clinical profile, including characteristic CSF findings, were established by Laundry in 1859 and Barre in 1916. Pathologic features of GBS were defined ill three landmark papers by Haymarker and Kernohan in 1949, Waksman and Adams in 1955, and Asbury, Arnason and Adams in 1969. Although GRS is considered to be an immune-mediated disorder, the exact immune mechanism(s) leading to demyelination is riot yet well established bill probably involves both cellular and humoral responses. Treatment modalities have progressed from massages and volatile liniments used by Landry to anticipatory and supportive care, plasma exchange, and intravenous immunoglobulin. Outcome continues to be generally favorable as originally emphasized. Clinical and electrophysiologic predictors of unfavorable outcome have been identified.
本文回顾了格林-巴利综合征(GBS)相关知识的发展历程。1859年朗德里(Laundry)和1916年巴雷(Barre)确定了其临床特征,包括典型的脑脊液检查结果。1949年海马克尔(Haymarker)和克诺汉(Kernohan)、1955年瓦克斯曼(Waksman)和亚当斯(Adams)以及1969年阿斯伯里(Asbury)、阿纳森(Arnason)和亚当斯发表的三篇具有里程碑意义的论文明确了GBS的病理特征。尽管GBS被认为是一种免疫介导的疾病,但导致脱髓鞘的确切免疫机制尚未完全明确,可能涉及细胞和体液反应。治疗方式已从朗德里使用的按摩和挥发性擦剂发展到预期性和支持性护理、血浆置换及静脉注射免疫球蛋白。正如最初所强调的,其预后总体仍然良好。已确定了不良预后的临床和电生理预测因素。