Neuronopathy and the Landry-Guillain-Barré Syndrome

Haymaker and Kernohan¹ first proposed the use of the term "Landry-Guillain-Barré syndrome" for the acute polyneuropathies, in which degenerative and ultimately inflammatory changes in the spinal and peripheral nerves are the primary lesions, with retrograde changes of varying degree in the cell bodies of the neurons as a later and secondary manifestation. In this issue of The Journal (p 1481) Ramos-Alvarez, Bessudo, and Sabin report neuropathologic studies on 25 fatal cases of an acute paralytic disease in Mexican children with clinical manifestations that are compatible with a diagnosis of the Landry-Guillain-Barré (LGB) syndrome, although often misdiagnosed as poliomyelitis because of normal values for protein in the cerebrospinal fluid.

The neuropathologic studies indicated that only ten of these patients exhibited changes similar to those of the LGB syndrome (70% of this group died 10 to 30 days after onset of paralysis), while the remaining 15, most of whom died within