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Guillain-Barre syndrome

Last reviewed: 20 Aug 2025
Last updated: 10 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

  • ptosis
  • altered level of consciousness
  • ataxia
Full details

Risk factors

  • preceding viral illness
  • preceding bacterial infection
  • preceding mosquito-borne viral infections
  • hepatitis E infection
  • immunization
  • cancer and lymphoma
  • older age
  • HIV infection
  • COVID-19 infection
  • male
Full details

Diagnostic investigations

1st investigations to order

  • nerve conduction studies
  • lumbar puncture
  • LFTs
  • spirometry
Full details

Investigations to consider

  • antiganglioside antibody
  • serology
  • stool culture
  • HIV antibodies
  • spinal MRI
  • Borrelia burgdorferi serology
  • cerebrospinal fluid (CSF) meningococcal polymerase chain reaction
  • CSF cytology
  • CSF angiotensin-converting enzyme
  • chest x-ray
  • CSF VDRL
  • CSF West Nile polymerase chain reaction
Full details

Emerging tests

  • ultrasound imaging of peripheral nerves

Treatment algorithm

ACUTE

ambulatory within 2 weeks of onset or nonambulatory within 4 weeks of onset

Contributors

Authors

Saiju Jacob, MD, DPhil, MRCP (UK), FRCP (Lon)

Consultant Neurologist

Queen Elizabeth Neurosciences Centre

University Hospital Birmingham

Birmingham

UK

Раскрытие информации

SJ has served as an international advisory board member for Alexion, Alnylam, ArgenX, Regeneron, Immunovant, and UCB pharmaceuticals. He is currently an expert panel member of the Myasthenia Gravis consortium for ArgenX, and has received speaker fees from Terumo BCT and Eisai.

Выражение благодарностей

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 topic.

Раскрытие информации

JBW, MTT, DJP, and PAK declare that they have no competing interests.

Рецензенты

Cigdem Akman, MD

Division of Pediatric Neurology

Columbia University College of Physicians and Surgeons

New York

NY

Раскрытие информации

CA declares that he has no competing interests.

Robert Hadden, FRCP, PhD

Consultant Neurologist

King's College Hospital

London

UK

Раскрытие информации

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

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet. 2016 Aug 13;388(10045):717-27.Полный текст  Аннотация

Stowe J, Andrews N, Wise L, et al. Investigation of the temporal association of Guillain-Barré syndrome with influenza vaccine and influenzalike illness using the United Kingdom General Practice Research Database. Am J Epidemiol. 2009 Feb 1;169(3):382-8.Полный текст  Аннотация

Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev. 2014 Sep 19;(9):CD002063.Полный текст  Аннотация

Lawn ND, Fletcher DD, Henderson RD, et al. Anticipating mechanical ventilation in Guillain-Barré syndrome. Arch Neurol. 2001 Jun;58(6):893-8.Полный текст  Аннотация

Hughes RA, Brassington R, Gunn AA, et al. Corticosteroids for Guillain-Barré syndrome. Cochrane Database Syst Rev. 2016 Oct 24;(10):CD001446.Полный текст  Аннотация

Walgaard C, Jacobs BC, Lingsma HF, et al. Second intravenous immunoglobulin dose in patients with Guillain-Barré syndrome with poor prognosis (SID-GBS): a double-blind, randomised, placebo-controlled trial. Lancet Neurol. 2021 Apr;20(4):275-83. Аннотация

Статьи, указанные как источники

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