Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • muscle weakness
  • respiratory distress
  • speech problems
  • paresthesia
  • back/leg pain
  • areflexia/hyporeflexia
  • facial weakness
  • bulbar dysfunction causing oropharyngeal weakness
  • extraocular muscle weakness
  • facial droop
  • diplopia
  • dysarthria
  • dysphagia
  • anisocoria
  • nonreactive pupil
  • dysautonomia
  • ophthalmoplegia

Other diagnostic factors

  • ptosis
  • altered level of consciousness
  • ataxia

Risk factors

  • preceding viral illness
  • preceding bacterial infection
  • preceding mosquito-borne viral infections
  • immunization
  • cancer and lymphoma
  • older age (mean 40 years)
  • HIV infection
  • male

Diagnostic investigations

1st investigations to order

  • nerve conduction studies
  • LP
  • LFT
  • spirometry
  • antiganglioside antibody
Full details

Investigations to consider

  • serology
  • stool culture
  • HIV antibodies
  • spinal MRI
  • Borrelia burgdorferi serology
  • CSF meningococcal PCR
  • CSF cytology
  • CSF ACE
  • CXR
  • CSF VDRL
  • CSF West Nile PCR
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Neurologist

Queen Elizabeth Neurosciences Centre

University Hospital Birmingham

Birmingham

UK

Disclosures

SJ declares that he has no competing interests.

Dr Saiju Jacob would like to gratefully acknowledge Dr John B. Winer, Dr Michael T. Torbey, Dr Dhruvil J. Pandya, and Dr Prem A. Kandiah, previous contributors to this monograph. JBW, MTT, DJP, and PAK declare that they have no competing interests.

Peer reviewers VIEW ALL

Division of Pediatric Neurology

Columbia University College of Physicians and Surgeons

New York

NY

Disclosures

CA declares that he has no competing interests.

Consultant Neurologist

King's College Hospital

London

UK

Disclosures

RH has been paid by Baxter Heathcare Ltd for membership of its neurology advisory board, and is a co-author of several studies referenced in this monograph.

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