Peripheral Neuropathies

A small but clinically important group of peripheral neuropathies with an inflammatory pathogenesis provide important insights into mechanisms of autoimmune disease. The pathology of the Guillain–Barre and Fisher syndromes is driven by antibody-dependent and complement-mediated attack on peripheral nerve axons or myelin. Much of the understanding of these diseases emerges from insights into the pathogenesis of the acute motor axonal neuropathy phenotype of GBS, first described in China half a century after GBS was described. Half a century further on and the pathogenesis of the chronic inflammatory neuropathies is less well understood and seems to be more T cell driven. Treatments based on rational pathogenic mechanisms are being tried in the therapy of these conditions with evidence for their efficacy supporting postulated mechanisms of disease.