From the Guidelines
Guillain-Barré Syndrome (GBS) is characterized by rapidly progressive ascending weakness, typically starting in the legs and progressing to the arms and cranial muscles, with symptoms often reaching their peak within 2 weeks.
Common Signs of GBS
- Weakness and sensory signs in the legs that progress to the arms and cranial muscles 1
- Rapidly progressive symmetrical weakness with absent or reduced tendon reflexes 1
- Sensory signs, such as numbness or tingling, in the legs and arms 1
- Cranial muscle weakness, including facial weakness and difficulty swallowing 1
- Respiratory failure, requiring mechanical ventilation in approximately 20% of patients 1
- Cardiac arrhythmias and blood pressure instability due to autonomic nervous system involvement 1
Clinical Variants of GBS
- Classic sensorimotor GBS: rapidly progressive symmetrical weakness and sensory signs with absent or reduced tendon reflexes 1
- Pure motor GBS: motor weakness without sensory signs 1
- Miller Fisher syndrome: ophthalmoplegia, ataxia, and areflexia 1
- Bickerstaff brainstem encephalitis: ophthalmoplegia, ataxia, areflexia, pyramidal tract signs, and impaired consciousness 1 These signs and symptoms can vary in severity and presentation, and a diagnosis of GBS is typically made based on a combination of clinical evaluation, electrophysiological studies, and cerebrospinal fluid analysis 1.
From the Research
Signs and Symptoms of Guillain-Barré Syndrome
- Rapidly progressive, symmetrical weakness of the extremities 2
- Respiratory insufficiency, which can occur in about 25% of patients 2
- Autonomic dysfunction, affecting up to two-thirds of patients 3
- Ascending symmetrical limb weakness, sensory disturbances, and absent or reduced deep tendon reflexes 3
- Tingling, progressive weakness, and pain 4
- Autonomic symptoms, such as cardiac arrhythmias, blood pressure instability, or urinary retention, which can occur in about two-thirds of patients 5
- Severe pain, which can occur in more than one-half of patients 5
- Progressive motor weakness, usually beginning in the legs and advancing proximally 5
- Bulbar muscle weakness, which can lead to aspiration pneumonia and atelectasis 6
- Ineffective cough, which can be a consequence of bulbar muscle weakness 6
Diagnostic Features
- Clinical features, such as progressive weakness and diminished or absent myotatic reflexes 5
- Cerebrospinal fluid testing, which shows increased protein levels but a normal white blood cell count 5
- Nerve conduction studies, which show a slowing, or possible blockage, of conduction 5
- Lumbar puncture and electrophysiological studies, which can help to substantiate the diagnosis and to differentiate demyelinating from axonal subtypes of GBS 2