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Deterioration after Guillain–Barré syndrome: recurrence, treatment-related fluctuation or CIDP?
  1. Robert D M Hadden
  1. Dr Robert D M Hadden, Department of Neurology, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; robert.hadden{at}nhs.net

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Guillain–Barré syndrome (GBS) is usually a monophasic illness, but may recur after an interval of many years in 1–6% of patients.1 The paper by Kuitwaard et al2 from one of the pre-eminent international GBS research groups describes the largest (retrospective) series of 32 patients with recurrent GBS and the first to compare these with non-recurrent GBS (see page 56). Patients with (Miller) Fisher syndrome (FS), younger age (<30 years) and milder disease (ie, ambulant) were more likely to have a recurrence: any of these factors at least doubled the risk of recurrence. Patients with FS, pure motor or oculomotor weakness usually experienced …

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