Guillain-Barré Syndrome (GBS)

Question 1

What is Guillain-Barré Syndrome (GBS)?

Answer 1

GBS is an acute, immune-mediated polyneuropathy causing muscle weakness and sensory loss, often triggered by infection.

Question 2

What are the typical symptoms of GBS?

Answer 2

Progressive symmetrical weakness, areflexia, paraesthesia, and sometimes autonomic dysfunction.

Question 3

What is the usual pattern of weakness in GBS?

Answer 3

Weakness typically starts in the lower limbs and ascends proximally (ascending paralysis).

Question 4

What is the most common trigger for GBS?

Answer 4

Infections such as Campylobacter jejuni, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and influenza.

Question 5

What is the pathophysiology of GBS?

Answer 5

It involves immune-mediated damage to peripheral nerves and myelin sheaths, often through molecular mimicry.

Question 6

What are the subtypes of GBS?

Answer 6

Acute inflammatory demyelinating polyneuropathy (AIDP), Miller Fisher syndrome, and acute motor axonal neuropathy (AMAN).

Question 7

What is the prevalence of GBS?

Answer 7

GBS occurs in approximately 1–2 cases per 100,000 people annually.

Question 8

What are the risk factors for GBS?

Answer 8

Recent infections (especially Campylobacter), recent vaccination, and certain autoimmune conditions.

Question 9

What is the clinical course of GBS?

Answer 9

Symptoms typically progress over days to weeks, plateau, and then gradually resolve over weeks to months.

Question 10

What autonomic symptoms can occur in GBS?

Answer 10

Tachycardia, bradycardia, hypotension, hypertension, and urinary retention.

Question 11

What are the hallmark clinical examination findings in GBS?

Answer 11

Symmetrical flaccid weakness, absent or reduced reflexes, and sensory abnormalities.

Question 12

What is the role of lumbar puncture in GBS diagnosis?

Answer 12

It typically shows raised protein with normal white cell count (albuminocytological dissociation).

Question 13

What is the role of nerve conduction studies in GBS?

Answer 13

They confirm peripheral nerve dysfunction and help differentiate between demyelinating and axonal subtypes.

Question 14

What are the differential diagnoses for GBS?

Answer 14

Chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, botulism, and transverse myelitis.

Question 15

What is the first-line treatment for GBS?

Answer 15

Intravenous immunoglobulin (IVIG) or plasma exchange.

Question 16

When is ventilatory support required in GBS?

Answer 16

In cases of respiratory muscle weakness or bulbar dysfunction leading to respiratory failure.

Question 17

What supportive care is important in GBS management?

Answer 17

Regular physiotherapy, pain management, prevention of venous thromboembolism, and monitoring for autonomic instability.

Question 18

What is the prognosis of GBS?

Answer 18

Most patients recover fully, though some may experience residual weakness or fatigue.

Question 19

What percentage of GBS patients require intensive care?

Answer 19

Approximately 25% of GBS patients require ventilatory support in an ICU.

Question 20

What is Miller Fisher syndrome?

Answer 20

A variant of GBS characterised by ophthalmoplegia, ataxia, and areflexia.

Question 21

What is the association between GBS and vaccines?

Answer 21

A very small risk of GBS has been associated with certain vaccines, such as the influenza vaccine.

Question 22

What role does physiotherapy play in GBS management?

Answer 22

Physiotherapy helps maintain muscle strength, prevent contractures, and promote functional recovery.

Question 23

What is the mortality rate of GBS?

Answer 23

Mortality is approximately 3–7%, often due to complications such as respiratory failure or autonomic instability.

Question 24

What is albuminocytological dissociation?

Answer 24

It refers to elevated protein levels in cerebrospinal fluid (CSF) without an increase in white blood cells, a hallmark of GBS.

Question 25

What long-term complications can result from GBS?

Answer 25

Chronic fatigue, residual weakness, pain, and psychological effects such as depression or anxiety.