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The outcome of Guillain-Barré polyneuritis is not always benign. Since no therapy of proven effectiveness is available and an immunologic etiology is presumed, plasma exchange treatment has been repeatedly used. We report on three patients with severe polyneuritis who were unable to walk. Two were also in acute respiratory failure. All the cases exhibited surprisingly good improvement correlating in time with plasma exchange. A review of the literature suggests that plasma exchange can at least be recommended in severe cases of Guillain-Barré acute polyneuritis with inability to walk. Treatment should be started within 1-2 weeks of onset of the disease.
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