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
Other diagnostic factors
- ptosis
- altered level of consciousness
- ataxia
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
Diagnostic investigations
1st investigations to order
- nerve conduction studies
- lumbar puncture
- LFTs
- spirometry
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
Emerging tests
- ultrasound imaging of peripheral nerves
Treatment algorithm
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
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
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Transverse myelitis
- Myasthenia gravis
- Lambert-Eaton myasthenic syndrome (LEMS)
Больше ОтличияРекомендации
- Diagnosis and treatment of Guillain-Barre syndrome in childhood and adolescence: an evidence- and consensus-based guideline
- Diagnosis and management of Guillain-Barré syndrome in ten steps
Больше РекомендацииЛифлеты для пациента
Lumbar puncture
Guillain-Barre syndrome
Больше Лифлеты для пациентаVideos
Diagnostic lumbar puncture in adults: animated demonstration
Tracheal intubation: animated demonstration
Больше ВидеоВойдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice
Использование этого контента попадает под действие нашего заявления об отказе от ответственности