Vasomotor Disturbance in Landry-Guillain-Barre Syndrome

Abstract

That vasomotor disturbances may be responsible for sudden death in the Landry-Guillain-Barré syndrome has been accepted ever since Osler¹² mentioned "paralysis of the heart" as a cause of death in this condition. The many reports implicating vasomotor and cardiac dysfunction in the fatal outcome are, however, difficult to evaluate because of the frequent accompanying respiratory failure that may have influenced the terminal picture. Thus the restlessness, sweating, cyanosis, coldness of the periphery of the limbs, and hypotension sometimes seen in this disorder have been ascribed to "peripheral circulatory failure"^9,11 but could equally well be due to hypoxia and hypercapnia. Changes in cardiac rate and rhythm have been reported independently of pyrexia, occurring usually as a terminal event.^17,18 These have been variously attributed to lesions of the autonomic nerve supply to the heart, respiratory insufficiency, or myocardial involvement.⁵ In 50 fatal cases examined by Haymaker and Kernohan