Guillain-Barre Syndrome Questions & Answers

Updated: May 04, 2018
  • Author: Michael T Andary, MD, MS; Chief Editor: Milton J Klein, DO, MBA  more...
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Questions & Answers

Overview

What is Guillain-Barre syndrome (GBS)?

How does Guillain-Barre syndrome (GBS) progress?

Which cranial nerve symptoms are typical in Guillain-Barre syndrome (GBS)?

Which autonomic nervous system (ANS) symptoms may be present in Guillain-Barre syndrome (GBS)?

Which respiratory symptoms are typical in Guillain-Barre syndrome (GBS)?

How is Guillain-Barre syndrome (GBS) diagnosed?

What is the role of needle electromyography (EMG) in the diagnosis of Guillain-Barre syndrome (GBS)?

How is respiratory muscle strength evaluated in Guillain-Barre syndrome (GBS)?

What is the role of CSF protein level in the diagnosis of Guillain-Barre syndrome (GBS)?

When is admission to an ICU considered for patients with Guillain-Barre syndrome (GBS)?

What should be included in intensive care for patients with Guillain-Barre syndrome (GBS)?

When is subcutaneous unfractionated or low-molecular-weight heparin (LMWH) indicated in the treatment of Guillain-Barre syndrome (GBS)?

Which immunomodulatory agent is most effective for the treatment of Guillain-Barre syndrome (GBS)?

What is the focus of physical therapy for Guillain-Barre syndrome (GBS)?

What is the focus of occupational therapy for Guillain-Barre syndrome (GBS)?

When is speech therapy indicated for Guillain-Barre syndrome (GBS)?

What is Guillain-Barre syndrome (GBS)?

What are the common variants of Guillain-Barre syndrome (GBS)?

How is Guillain-Barre syndrome (GBS) diagnosed?

How is Guillain-Barre syndrome (GBS) usually treated?

When was Guillain-Barre syndrome (GBS) first recognized?

How does Guillain-Barre syndrome (GBS) develop?

What is the role of C jejuni infection in the pathogenesis of Guillain-Barre syndrome (GBS)?

What are pathologic findings in Guillain-Barre syndrome (GBS)?

Is there symptom overlap between the variants of Guillain-Barre syndrome (GBS)?

What are the characteristics of the acute inflammatory demyelinating polyneuropathy (AIDP) subtype of Guillain-Barre syndrome (GBS)?

What are the characteristics of the acute motor axonal neuropathy (AMAN) subtype of Guillain-Barre syndrome (GBS)?

What are the characteristics of the acute motor-sensory axonal neuropathy (AMSAN) subtype of Guillain-Barre syndrome (GBS)?

What are the characteristics of the Miller-Fisher syndrome (MFS) subtype of Guillain-Barre syndrome (GBS)?

What are the characteristics of the acute panautonomic neuropathy variant of Guillain-Barre syndrome (GBS)?

What are the characteristics of the pure sensory variant of Guillain-Barre syndrome (GBS)?

What are the characteristics of the pharyngeal-cervical-brachial variant of Guillain-Barre syndrome (GBS)?

Do combinations of Guillain-Barre syndrome (GBS) variants occur?

What is the general etiology of Guillain-Barre syndrome (GBS)?

What is the incidence of C jejuni infection in Guillain-Barre syndrome (GBS)?

What symptoms suggest C jejuni infection in Guillain-Barre syndrome (GBS)?

What is the role of C jejuni antibodies in the etiology of Guillain-Barre syndrome (GBS)?

What is the incidence of cytomegalovirus (CMV) infection in Guillain-Barre syndrome (GBS)?

What symptoms suggest cytomegalovirus (CMV) infection in Guillain-Barre syndrome (GBS)?

In addition to C jejuni and cytomegalovirus (CMV), which infectious agents are etiologic factors in Guillain-Barre syndrome (GBS)?

Does Zika virus cause Guillain-Barre syndrome (GBS)?

Which vaccines have been proven to cause Guillain-Barre syndrome (GBS)?

Do influenza vaccinations increase the risk of developing Guillain-Barre syndrome (GBS)?

Do vaccines increase or decrease the risk of developing Guillain-Barre syndrome (GBS)?

Which medications increase the risk of developing Guillain-Barre syndrome (GBS)?

What are the less common causes of Guillain-Barre syndrome (GBS)?

What is the incidence of Guillain-Barre syndrome (GBS) in the US?

What is the global incidence of Guillain-Barre syndrome (GBS)?

Does Guillain-Barre syndrome (GBS) have a racial predilection?

Is Guillain-Barre syndrome (GBS) more common in males or females?

Is Guillain-Barre syndrome (GBS) more common in certain age groups?

What is the prognosis of Guillain-Barre syndrome (GBS)?

What is the mortality rate associated with Guillain-Barre syndrome (GBS)?

What are potential causes of death in individuals with Guillain-Barre syndrome (GBS)?

Which patients are at increased risk for Guillain-Barre syndrome (GBS)-related death?

What is the prevalence of persistent motor sequelae due to Guillain-Barre syndrome (GBS)?

How quickly do sequelae of Guillain-Barre syndrome (GBS) resolve?

What are the long-term sequelae of Guillain-Barre syndrome (GBS)?

Is persistent fatigue a complication of Guillain-Barre syndrome (GBS)?

Does Guillain-Barre syndrome (GBS) negatively affect psychosocial status?

What are the negative prognostic factors of Guillain-Barre syndrome (GBS)?

Is relapse of Guillain-Barre syndrome (GBS) possible after treatment?

Which factors may increase the risk of Guillain-Barre syndrome (GBS) relapse?

What information should patients be given regarding Guillain-Barre syndrome (GBS)?

Presentation

What is the focus of the history in patients with suspected Guillain-Barre syndrome (GBS)?

What is the typical disease progression of Guillain-Barre syndrome (GBS)?

Does an atypical presentation of Guillain-Barre syndrome (GBS) increase the risk of misdiagnosis?

What is the classic presentation of weakness in Guillain-Barre syndrome (GBS)?

Which symptoms suggest cranial nerve involvement in Guillain-Barre syndrome (GBS)?

Which sensory symptoms are typically present in Guillain-Barre syndrome (GBS)?

How common is pain in Guillain-Barre syndrome (GBS)?

What is the typical presentation of pain in Guillain-Barre syndrome (GBS)?

Which autonomic nervous system (ANS) symptoms may be present in Guillain-Barre syndrome (GBS)?

What is the incidence of autonomic dysfunction in Guillain-Barre syndrome (GBS)?

What are typical respiratory symptoms in Guillain-Barre syndrome (GBS)?

What are the most common antecedent illnesses in patients with suspected Guillain-Barre syndrome (GBS)?

What are the most common etiologic triggers of Guillain-Barre syndrome (GBS)?

What are the likely physical findings in Guillain-Barre syndrome (GBS)?

How does facial weakness present in Guillain-Barre syndrome (GBS)?

How common is ophthalmoparesis in patients with Guillain-Barre syndrome (GBS)?

How does lower extremity weakness present in Guillain-Barre syndrome (GBS)?

Are sensory changes common in Guillain-Barre syndrome (GBS)?

How are reflexes affected in Guillain-Barre syndrome (GBS)?

DDX

Which disorders should be considered in the differential diagnoses of Guillain-Barre syndrome (GBS)?

What are the differential diagnoses for Guillain-Barre Syndrome?

Workup

What is the role of blood testing in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of electromyography (EMG) and nerve conduction studies (NCS) in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of pulmonary function monitoring in the management of Guillain-Barre syndrome (GBS)?

What is the role of CSF studies in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of imaging studies in the diagnosis of Guillain-Barre syndrome (GBS)?

Which studies should be included in a basic peripheral neuropathy workup for Guillain-Barre syndrome (GBS)?

Which biochemical screens should be performed in the workup of suspected Guillain-Barre syndrome (GBS)?

What is the role of serologic studies in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of serum autoantibodies testing in the diagnosis of Guillain-Barre syndrome (GBS)?

Which specific antibodies are frequently found in patients with Guillain-Barre syndrome (GBS)?

What is the purpose of nerve conduction studies in the diagnosis of Guillain-Barre syndrome (GBS)?

Which findings in nerve conduction studies indicate demyelination in patients with Guillain-Barre syndrome (GBS)?

In addition to demyelination, which nerve conductions study findings suggest Guillain-Barre syndrome (GBS)?

Is needle exam in nerve conduction studies useful in the diagnosis of Guillain-Barre syndrome (GBS)?

How often are neurophysiologic testing findings negative in Guillain-Barre syndrome (GBS)?

What is the role of maximal inspiratory pressures and vital capacities in the management of Guillain-Barre syndrome (GBS)?

What is the role of forced vital capacity (FVC) testing in the management of Guillain-Barre syndrome (GBS)?

How often should negative inspiratory force (NIF) be monitored in Guillain-Barre syndrome (GBS)?

What is the role of CSF protein level testing in Guillain-Barre syndrome (GBS)?

What is the role of MRI in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of muscle biopsy in the diagnosis of Guillain-Barre syndrome (GBS)?

What is the role of ECG in the diagnosis of Guillain-Barre syndrome (GBS)?

Which histologic findings suggest Guillain-Barre syndrome (GBS)?

Treatment

When should patients diagnosed with Guillain-Barre syndrome (GBS) be admitted to a hospital?

What type of continued care is required for Guillain-Barre syndrome (GBS) after initial treatment?

Does early recognition and treatment improve the long-term prognosis of Guillain-Barre syndrome (GBS)?

Which immunotherapy agent is most effective in the treatment of Guillain-Barre syndrome (GBS)?

Are corticosteroids effective for the treatment of Guillain-Barre syndrome (GBS)?

What is the required prehospital care for patients with Guillain-Barre syndrome (GBS)?

How should patients with Guillain-Barre syndrome (GBS) be managed in the emergency department (ED)?

Which treatments for Guillain-Barre syndrome (GBS) are administered in the ICU?

What respiratory therapy is necessary for Guillain-Barre syndrome (GBS) in the ICU?

What is the role of cardiac monitoring for Guillain-Barre syndrome (GBS) in the ICU?

What is the role of nutrition support for Guillain-Barre syndrome (GBS) in the ICU?

How should infection be prevented in patients with Guillain-Barre syndrome (GBS) in the ICU?

How are the complications of immobility prevented in the ICU in patients with Guillain-Barre syndrome (GBS)?

How are bowel and bladder dysfunction managed in the ICU in patients with Guillain-Barre syndrome (GBS)?

How should psychiatric complications be managed in the ICU in patients with Guillain-Barre syndrome (GBS)?

Is inpatient rehabilitation required for patients with Guillain-Barre syndrome (GBS)?

How does physical therapy progress in the early acute phase of Guillain-Barre syndrome (GBS)?

Is physical recovery possible for patients with Guillain-Barre syndrome (GBS)?

What are the goals of occupational and recreational therapies in patients with Guillain-Barre syndrome (GBS)?

What is the goal of speech therapy in patients with Guillain-Barre syndrome (GBS)?

How effective is plasma exchange in the treatment of Guillain-Barre syndrome (GBS)?

When is IVIG preferred over plasma exchange in the treatment of Guillain-Barre syndrome (GBS)?

Is combining plasma and IVIG an effective treatment for Guillain-Barre syndrome (GBS)?

Is immunotherapy effective in children with Guillain-Barre syndrome (GBS)?

Is eculizumab an effective treatment for Guillain-Barre syndrome (GBS)?

Are corticosteroids effective in the treatment of Guillain-Barre syndrome (GBS)?

Is methylprednisolone effective in the treatment of Guillain-Barre syndrome (GBS)?

What is the approach to pain treatment in Guillain-Barre syndrome (GBS)?

Are narcotics used to treat pain in Guillain-Barre syndrome (GBS)?

When should adjunct medications for pain be considered in Guillain-Barre syndrome (GBS)?

Which nonpharmacologic pain relief therapies can be considered in Guillain-Barre syndrome (GBS)?

Is immune adsorption an effective treatment for Guillain-Barre syndrome (GBS)?

How is thromboembolism prevented in patients with Guillain-Barre syndrome (GBS)?

Which specialists should be consulted for Guillain-Barre syndrome (GBS)?

Is long-term follow-up indicated for Guillain-Barre syndrome (GBS)?

How is long-term fatigue managed in Guillain-Barre syndrome (GBS)?

Which long-term psychosocial changes can result from Guillain-Barre syndrome (GBS)?

Medications

Which patients are most likely to benefit from immunotherapy in Guillain-Barre syndrome (GBS)?

Which medications in the drug class Immunomodulatory Agents are used in the treatment of Guillain-Barre Syndrome?

Which medications in the drug class Low Molecular Weight Heparin are used in the treatment of Guillain-Barre Syndrome?

Which medications in the drug class Analgesics are used in the treatment of Guillain-Barre Syndrome?

Which medications in the drug class Anticonvulsants are used in the treatment of Guillain-Barre Syndrome?

Which medications in the drug class Tricyclic Antidepressants are used in the treatment of Guillain-Barre Syndrome?