Recurrent Guillain–Barré syndrome presenting stereotypic manifestations, positive antiganglioside antibodies, and rapid recovery

• Recurrent Guillain–Barré syndrome (rGBS) was rare (3/117, 2.6%) in our cohort.
• rGBS exhibited stereotypical symptoms, serum antiganglioside antibodies, and rapid recovery.
• Certain types of host factor and reversible mechanism may play an important role in rGBS.

ObjectiveRecurrent Guillain–Barré syndrome (rGBS) has been described as a rare entity with distinct characteristics. However, little is known about rGBS in Asian group. The aim of this study was to identify the incidence and clinical course of rGBS, and to determine its clinical/pathophysiological implications.MethodsThe consecutive data of 117 GBS patients were retrieved from a single university-based hospital in Korea and analyzed in terms of clinical, serological, electrophysiological aspects.ResultsA thorough review revealed that three (2.6%) of the enrolled patients had experienced more than two definite recurrent attacks of GBS. Interestingly, all three cases exhibited clinically stereotypical features, serum antiganglioside antibodies, and rapid recovery after intravenous immunoglobulin treatment. Clinical, serological, and electrophysiological features of rGBS cases were described in detail.ConclusionThe stereotypic presentation of each attack in this variant suggests the importance of both host and genetic factors for the clinical manifestations. In addition, the simultaneous presence of serum antiganglioside antibodies and rapid recovery implicate reversible nerve conduction failure as the mechanism of rGBS. These features are different from typical monophasic GBS and acute onset of chronic inflammatory demyelinating polyneuropathy.