Guillain-Barré syndrome

1. Big picture

Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy. It classically presents with rapidly progressive, mostly symmetric ascending weakness, hypo- or areflexia, sensory symptoms, possible cranial nerve involvement, autonomic dysfunction, and sometimes respiratory failure.

The key exam sentence:

GBS = acute/subacute ascending flaccid weakness + absent reflexes + albuminocytologic dissociation in CSF + abnormal nerve conduction.

The disease is dangerous because the patient can deteriorate quickly due to:

• respiratory muscle paralysis;
• bulbar weakness with aspiration;
• severe autonomic dysfunction;
• arrhythmia or blood pressure instability;
• deep vein thrombosis and pulmonary embolism due to immobility.

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