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Síndrome de Guillain-Barré

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  • Theory
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Last reviewed: 13 Jul 2025
Last updated: 10 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • fraqueza muscular
  • parestesia
  • dorsalgia/dor nas pernas
  • dificuldade respiratória
  • problemas de fala
  • arreflexia/hiporreflexia
  • fraqueza facial
  • disfunção bulbar que causa fraqueza orofaríngea
  • fraqueza muscular extraocular
  • paralisia facial
  • diplopia
  • disartria
  • disfagia
  • disautonomia
  • disfunção pupilar
  • oftalmoplegia
Full details

Other diagnostic factors

  • ptose
  • nível alterado de consciência
  • ataxia
Full details

Risk factors

  • doença viral precedente
  • infecção bacteriana precedente
  • infecção viral de transmissão por mosquito precedente
  • infecção por hepatite E
  • imunização
  • câncer e linfoma
  • idade avançada
  • Infecção pelo vírus da imunodeficiência humana (HIV)
  • Infecção por COVID-19
  • sexo masculino
Full details

Diagnostic tests

1st tests to order

  • estudos da condução nervosa
  • punção lombar
  • TFHs
  • espirometria
Full details

Tests to consider

  • anticorpo anti-gangliosídeo
  • sorologia
  • coprocultura
  • anticorpos antivírus da imunodeficiência humana (anti-HIV)
  • ressonância nuclear magnética (RNM) espinhal
  • sorologia para Borrelia burgdorferi
  • reação em cadeia da polimerase para meningococos para o líquido cefalorraquidiano (LCR)
  • citologia do líquido cefalorraquidiano (LCR)
  • enzima conversora de angiotensina no LCR
  • radiografia torácica
  • VDRL no líquido cefalorraquidiano (LCR)
  • reação em cadeia da polimerase do Nilo Ocidental para o LCR
Full details

Emerging tests

  • ultrassonografia dos nervos periféricos

Treatment algorithm

ACUTE

pacientes deambulantes ou não deambulantes diagnosticados nas 2 ou 4 semanas, respectivamente, após o início dos sintomas

Contributors

Authors

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

Consultant Neurologist

Queen Elizabeth Neurosciences Centre

University Hospital Birmingham

Birmingham

UK

Disclosures

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.

Acknowledgements

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.

Disclosures

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

Peer reviewers

Cigdem Akman, MD

Division of Pediatric Neurology

Columbia University College of Physicians and Surgeons

New York

NY

Disclosures

CA declares that he has no competing interests.

Robert Hadden, FRCP, PhD

Consultant Neurologist

King's College Hospital

London

UK

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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

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.Full text  Abstract

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

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

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

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. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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