Studies on endemic polyradiculoneuritis (Guillain-Barre Syndrome) in the middle western part (Chugoku and Shikoku) of Japan. Part 2. Clinical Picture

The author statistically reviewed 125 cases of Guillain-Barre disease seen at the pediatric clinic of the Okayama University Hospital from 1949 to 1955, and the following results were obtained. 1. Most of the cases had a sudden onset without fever. 2. Flaccid symmetrical motor paralysis was observed in all cases. The paralysis began at the lower extremities in 79% of all cases and was more marked at the distal part than the proximal. 3. The paralysis became most severe from 3 to 10 days after the onset of the disease and then showed a rapid recovery. Tendon reflexes, however, remained weak or disappeared for longer period even after the recovery of motor function. 4. Syndrome of posterior spinal nerve root irritation was characteristic and lasted for longer period. 5. The facial nerve was most frequently affected among the cranial nerves. 6. The pleocytosis in the spinal fluid was found in no case, but dissociatio albumino-cytologique was observed in 81.3% of all cases. 7. Nineteen cases (15.2%) died from acute bulbar paralysis. 8. Reinvestigation of 83 cases after 8 months to 6 years revealed complete cure of all cases except for one case with slight weakness of motor power