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To the Editor:
We read with interest the article by Capasso et al.1 and the accompanying Editorial2 concerning two patients with pure motor Guillain-Barré syndrome (GBS), early nerve conduction block (CB), preserved motor conduction velocity (MCV), and high titers of anti-ganglioside antibodies. They conclude that these cases may represent a new axonal GBS variant with nerve CB induced by anti-ganglioside antibodies. We would like to offer an alternative explanation. Starting from current criteria for electrophysiologic classification of GBS, it seems that there is evidence of demyelination at initial electrophysiologic examinations: 1) in both patients, MCV of ulnar nerves (above elbow–below elbow segment) less than 85% of lower limit of normal; and 2) in Patient 2, distal motor latencies (DML) of three nerves greater than 120% of upper limit of normal.1 It is worth noting that DML prolongation for left median nerve is not slight, as stated by the authors, but marked (according to figure 1D, about 6.5 ms representing 150% of upper …
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