Question

“Like a polio ward from the 1950s” is how Guy McKhann, M.D., a neurology specialist at John Hopkins School of Medicine, describes a ward of Beijing Hospital that he visited on a trip to China in 1986. Dozens of paralyzed children---some attached to respirators to assist their breathing--filled the ward to overflowing. The chinese doctors thought the children had Guillain-Barre syndrome (GBS), a rare paralytic condition, but Dr. McKhann wasn’t convinced. There were simply too many stricken children for the illness to be the rate Guillain-Barre syndrome. Was it polio--as some of the Beijing staff feared? Or was it another illness, perhaps one that had not yet been discovered? Dr. McKhann decided to perform nerve conduction tests on some of the paralyzed children in Beijing Hospital. He found that although the rate of conduction along the children’s nerves was normal, the strength of the summed action potentials traveling down the nerve was greatly diminished.Dr. McKhann then asked to see autopsy reports on some of the children who had died of their paralysis at Beijing Hospital. In the reports, pathologists noted that the patients had normal myelin but damaged axons. In some cases, the axon had been completely destroyed, leaving only a hollow shell of myelin.

Do the results of Dr. McKhann’s investigation suggest that the Chinese children had classic GBS? Why or why not?

Answer 1

Explanation: Autopsy reports on children who died from the mysterious disease displayed that the axons were completely damaged but the myelin was found to be intact.

Whereas, Classic GBS is a demyelinating disease which affects both sensory and motor neurons alike. The children had normal sensory functions, and nerve conduction tests and histological studies also showed normal myelin. Thus, it is reasonable to conclude that the disease can not be classic GBS.