Serial cerebrospinal fluid neurofilament heavy chain levels in severe Guillain-Barré syndrome

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Abstract

Introduction:

Proximal axonotmesis results in the release of neurofilament (Nf) proteins into the cerebrospinal fluid (CSF) in patients with Guillain-Barré syndrome (GBS). High CSF levels of the phosphorylated form of Nf-heavy chain (NfHSMI35) at GBS onset have been reported to be a poor prognostic marker, but routine measurement of CSF NfHSMI35 levels has not been done and the longitudinal profile of CSF NfHSMI35 levels in GBS is not known.

Methods:

This prospective case series describes the clinical, neurophysiological, and biomarker characteristics of 3 patients with severe GBS.

Results:

High and increasing levels of CSF NfHSMI35 in serial CSF samples were associated with poor clinical and electrophysiological outcome.

Conclusions:

These data further suggest that CSF NfHSMI35 could be a prognostic biomarker which might indicate the development of retrograde axonal degeneration or additional proximal axonal damage during the course of GBS.Muscle Nerve, 2013

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