Guillain-Barré Syndrome, Greater Paris Area

We studied 263 cases of Guillain-Barré syndrome from 1996 to 2001, 40 % of which were associated with a known causative agent, mainly Campylobacter jejuni (22%) or cytomegalovirus (15%). The cases with no known agent (60%) peaked in winter, and half were preceded by respira-tory infection, influenzalike syndrome, or gastrointestinal illness. Guillain-Barré syndrome (GBS) is a state of acute flac-cid paralysis thought, in most cases, to result from an aberrant immune response triggered by microbial infec-tions (1). Studies in Western countries have reported evi-dence of recent infection with Campylobacter jejuni in 15% to 40 % of GBS cases and with cytomegalovirus (CMV) in 5 % to 20 % of cases (1–5). Recent infection with Epstein-Barr virus (EBV) or Mycoplasma pneumoniae was less fre-quent (1%–2 % each) (1–5). No agent was identified in 60% to 70 % of cases, although the patients often had a history of respiratory or gastrointestinal infection (1,2). Previous studies have failed to identify any clear season-al distribution of GBS cases in Europe and North America. It has been suggested that this failure to demonstrate sea-sonality in GBS is because most prevalent antecedent infec-tions have inverse seasonal distributions (6). We tested this hypothesis to provide new insight into infectious agents associated with GBS in Western countries