We report the neurological features observed in 4 patients who developed a clinically typical Guillain-Barré syndrome. Electrophysiological and histological data displayed an unusual number of axonal lesions, although these were always associated with demyelination. These cases must be distinguished from the rare cases of Guillain-Barré syndrome with pure axonal lesions. Three patients had a poor functional recovery. This confirms the more severe prognosis of Guillain-Barré syndrome with major axonal degenerative changes.