Difference in autonomic involvement between different subtypes of Guillain Barre syndrome
Is there a difference in autonomic involvement between different subtypes of Guillain Barre syndrome ?
There are two major subtypes of GBS: demyelinating, or acute inflammatory demyelinating neuropathy (AIDP), and axonal, or acute motor axonal neuropathy (AMAN).
They differ in pathogenesis, clinical course, and response to treatment.
They also differ in the extent of autonomic involvement.
AIDP patients show the more serious manifestations of cardiosympathetic hyperactivity.
Some authors suggest that the long, myelinated, preganglionic neurons of the vagal fibers are vulnerable to demyelinating processes, which eventually leads to the predominance of the sympathetic system involvement in AIDP patients.
Others postulate that demyelination of both afferent and efferent limbs of the baroreflex loop are the leading cause of tachycardia in these patients.
On the other hand, autonomic manifestations in AMAN patients are limited to hypoactivity of sudomotor and skin vasomotor function.
