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A form of Guillain-Barre syndrome (GBS) that occurs in persons or families with a genetic predisposition to the acute or chronic forms of GBS. Note that GBS is considered to be a complex multifactorial disorder with both genetic and environmental factors, and families with clear Mendelian inheritance have been rarely reported: a mutation in the PMP22 gene (601097) on chromosome 17 was identified in a single family with the acute (AIDP) and chronic (CIDP) forms of inflammatory demyelinating polyneuropathy.
Features include: Acute demyelinating polyneuropathy.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 1 | Acute demyelinating polyneuropathy |
PMP22 function has not been fully characterized.
Guillain-Barre syndrome, familial is associated with mutations in the PMP22 gene on chromosome 17.
More than 26 single PMP22 nucleotide variants have been reported to cause HNPP. It is not clear if there are genotype-phenotype correlations with these variants since each is limited to a few families . Of note, six families with the PMP22 frameshift variant have a typical HNPP phenotype and are also more likely to have an associated clinically evident motor/sensory neuropathy mimicking Charcot-Marie-Tooth neuropathy type 1 (CMT1; see CMT Overview) . A similar phenotype has been described in individuals with other single-nucleotide variants in PMP22 [, , , , ].
Hereditary neuropathy with liability to pressure palsies (HNPP) should be suspected in individuals with the following clinical findings, electrophysiologic studies, imaging studies, and family history.
Typical clinical findings
Recurrent acute focal sensory and motor neuropathies mainly at entrapment sites
Painless nerve palsy after minor trauma or compression
No approved treatments are currently available for Guillain-Barre syndrome, familial. The disease remains an area of unmet medical need.
To establish the extent of disease and needs in an individual diagnosed with hereditary neuropathy with liability to pressure palsies (HNPP), the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
Table 2.
Table 3.
Recommended Surveillance for Individuals with HNPP
System/Concern | Evaluation | Frequency
| Screening neurologic exam focused on muscle atrophy, strength, sensory loss | Annually
Eval for neuropathic pain
No clinical trials have been registered for Guillain-Barre syndrome, familial.
300 publications have been identified in PubMed for Guillain-Barre syndrome, familial. Kisho has analyzed 87 by research type. Research spans Review / Meta-Analysis (48%), Epidemiology / Natural History (20%), and Diagnostic / Biomarker (8%).
Research Type | Count | % of Total |
|---|---|---|
Research summaries | 42 | 48% |
Data assembled from 6 of 12 sources · Last updated Sep 20, 2026, 1:49 AM UTC
Online Mendelian Inheritance in Man
Genetic and Rare Diseases Info Center
Hereditary neuropathy with liability to pressure palsies (HNPP) is characterized by recurrent acute sensory and motor neuropathy in a single or multiple nerves. The most common initial manifestation is the acute onset of a non-painful focal sensory and motor neuropathy in a single nerve (mononeuropathy) . Some individuals experience transient sensory phenomena without weakness. A history of actual physical minor compression of the nerve may or may not be present. The first attack generally occurs in the second or third decade (age range: 2-70 years; mean 37 years) but could be at any age. With the widespread availability of molecular genetic testing, reports of early onset have become increasingly common .
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Penetrance is 100% but expressivity is highly variable even within the same family. For an unknown reason men typically have more severe clinical nerve palsies and electrophysiologic studies.
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Evidence on physical examination of previous nerve palsy such as focal weakness, atrophy, or sensory loss
Complete spontaneous recovery from neuropathies (in 50% of occurrences) within weeks
Mild-to-moderate pes cavus foot deformity (in 4%-40% of individuals)
Electrophysiologic studies
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
The signs and symptoms of compression neuropathy in hereditary neuropathy with liability to pressure palsies (HNPP) are the same as those of the acquired type. Thus, HNPP is part of the broad differential diagnosis of both compression neuropathies and general peripheral neuropathies, including the hereditary neuropathies and Charcot-Marie-Tooth (CMT) syndrome (see CMT Overview).
Compression neuropathies. Pressure palsies are most commonly the result of environmentally acquired physical compression of peripheral nerves. The most common are carpal tunnel syndrome with compression of the median nerve at the wrist,* peroneal pressure palsy with compression of the superficial peroneal nerve at the fibular head, and ulnar nerve compression at the elbow.
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Genetic testing for PMP22 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Guillain-Barre syndrome, familial has been reported in the published literature.
System/Concern | Evaluation | Comment
| Neurologic eval | To evaluate for pain determine:
Extent of weakness atrophy, pes cavus, gait stability, sensory loss
If there are assoc manifestations (e.g., focal atrophy or sensory loss in less common sites of entrapment)
If affected person /or a family member has had episodes of acute transient nerve palsy
| Orthopedics/ physical medicine rehab/ PT/OT evaluation | To incl assessment of:
Gross motor fine motor skills need for PT (to improve gross motor skills) /or OT (to improve fine motor skills)
Feet for evidence of pes cavus need for AFOs, specialized shoes
Mobility, ADL, need for adaptive devices
Need for handicapped parking
Genetic
counseling | By genetics professionals1 | To inform affected persons families re nature, MOI, implications of HNPP to facilitate medical personal decision making
Family support
resources | Assess need for:
Community resources (e.g., Parent to Parent);
Social work involvement for parental support.
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Activities that are risk factors for pressure palsies include the following :
Prolonged sitting with legs crossed
Prolonged leaning on elbows
Occupations requiring repetitive movements of the wrist
Rapid weight loss
Wearing a heavy backpack on shoulders
Particular care must be taken in positioning during surgery (particularly knee surgery) to avoid nerve compression . Vincristine, commonly used in the chemotherapy of lymphoma, has been reported to exacerbate HNPP, as other potential neurotoxic chemotherapy or agents . Medications that are toxic or potentially toxic to persons with CMT comprise a spectrum of risk ranging from definite high risk to negligible risk. See the Charcot-Marie-Tooth Association website (pdf) for an up-to-date list.
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
View trials for Guillain-Barre syndrome, familial
OT (fine motor skills) ADL
| For pressure sores or poorly fitting footwear | Annually by physician; at more frequent intervals by affected person
ADL = activities of daily living; OT = occupational therapy; PT = physical therapy
Source: GeneReviews — "Hereditary Neuropathy with Liability to Pressure Palsies"
Disease patterns and progression |
17 |
20% |
Testing and diagnosis research | 7 | 8% |
Patient case studies | 6 | 7% |
Laboratory research | 6 | 7% |
Clinical study results | 5 | 6% |
Other research | 3 | 3% |
New treatment approaches | 1 | 1% |
Ginsberg M (2026). [PMID: 42124394](https://pubmed.ncbi.nlm.nih.gov/42124394/). *Muscle Nerve*. [Epidemiology / Natural History]
Pelouto F (2026). [PMID: 41739223](https://pubmed.ncbi.nlm.nih.gov/41739223/). *J Neurol*. [Epidemiology / Natural History]
De León-Muñoz A (2026). [PMID: 41038424](https://pubmed.ncbi.nlm.nih.gov/41038424/). *Arch Phys Med Rehabil*. [Review / Meta-Analysis]
Arends S (2026). [PMID: 41656826](https://pubmed.ncbi.nlm.nih.gov/41656826/). *Muscle Nerve*. [Diagnostic / Biomarker]
Williams SE (2026). [PMID: 41797542](https://pubmed.ncbi.nlm.nih.gov/41797542/). *Hum Vaccin Immunother*. [Review / Meta-Analysis]
Luijten LWG (2026). [PMID: 41526144](https://pubmed.ncbi.nlm.nih.gov/41526144/). *Handb Clin Neurol*. [Review / Meta-Analysis]
Elliott EJ (2026). [PMID: 41785149](https://pubmed.ncbi.nlm.nih.gov/41785149/). *MSMR*. [Epidemiology / Natural History]
Bellanti R (2026). [PMID: 41055073](https://pubmed.ncbi.nlm.nih.gov/41055073/). *Brain*. [Epidemiology / Natural History]
Zohar-Dayan E (2026). [PMID: 41646039](https://pubmed.ncbi.nlm.nih.gov/41646039/). *Muscle Nerve*. [Basic Science / Preclinical]
Karam C (2026). [PMID: 41263294](https://pubmed.ncbi.nlm.nih.gov/41263294/). *Muscle Nerve*. [Basic Science / Preclinical]