Guillian-Barre Syndrome

Question 1

What is Guillian-Barre Syndrome?

Answer 1

acute paralytic polyneuropathy caused by autoantibodies attacking the myelin sheath and neuronal axons of multiple nerves in the PNS.

Question 2

Classical presentation of Guillian-Barre Syndrome?

Answer 2

• symmetrical ascending limb weakness starting in the feet.
• peripheral loss of sensation
• reduced reflexes
• neuropathic pain

Question 3

Guillian-Barre syndrome classically follows what type of infection? What are the main pathogens involved? (3)

Answer 3

GI and URTI - campylobacter, EBV and CMV

Question 4

Diagnosis of Guillian-Barre syndrome? (2)

Answer 4

Clinical diagnosis. Useful investigations include:

• nerve conduction tests (reduced signals)
• LP: raised proteins (normal glucose and WBC)

Question 5

Management of Guillian-Barre syndrome?

Answer 5

1. IVIG
2. Plasma exchange (if IVIG not appropriate)
3. supportive care - analgesics
4. VTE prophylaxis

Question 6

When does the symptoms of Guillian-Barre syndrome usually peak?

Answer 6

2-4 weeks

Question 7

How long after an infection does Guillian-Barre syndrome usually occur?

Answer 7

4 weeks

Question 8

What percentage of patients usually recover from Guillian-Barre syndrome with no residual neuro symptoms?

Answer 8

~80%

Question 9

What percentage of patients have residual neurological symptoms after Guillian-Barre syndrome?

Answer 9

~15%

Question 10

What percentage of patients die due to Guillian-Barre Syndrome?

Answer 10

~5%