The physiological basis for symptoms in Guillain-Barré syndrome.

An experimental humorally induced focal demyelinative lesion of peripheral nerve is described. Associated with this lesion, conduction block appears rapidly--as early as 30 minutes in some axons--and progresses to completion within four hours. Small-diameter myelinated axons block before those of larger diameter. Recovery of conduction occurs in 6 to 15 days. This model provides a basis for understanding the time course of onset and recovery in acute Guillain-Barré syndrome and raises the possibility that a humoral mechanism might be important in the pathogenesis of the disease.