What is Expert Express GBS?
"Expert Express GBS" does not appear to be a recognized medical term, diagnostic tool, or treatment protocol in the current medical literature or clinical guidelines for Guillain-Barré Syndrome. Based on comprehensive review of international GBS guidelines from Nature Reviews Neurology 1 and the European Academy of Neurology/Peripheral Nerve Society 2, no reference to "Expert Express GBS" exists.
Possible Interpretations
If Referring to Rapid Expert Assessment of GBS
The term might be attempting to describe expedited expert evaluation of suspected Guillain-Barré Syndrome, which is critical given that:
- Approximately 20% of GBS patients develop respiratory failure requiring mechanical ventilation 3, 4, often without obvious dyspnea 3
- Most patients reach maximum disability within 2 weeks 1, 3, making rapid diagnosis essential
- Treatment should begin immediately when GBS is suspected, without waiting for confirmatory tests 3
If Referring to Prognostic Scoring Systems
You may be confusing this with established GBS assessment tools:
- mEGOS (modified Erasmus GBS Outcome Score): Should be calculated on admission to predict outcome 1, 2
- mEGRIS (modified Erasmus GBS Respiratory Insufficiency Score): Used to assess risk of requiring artificial ventilation 2
- GBS Disability Scale: Recommended for assessing functional disability 3
Critical Assessment Priorities in GBS
When evaluating suspected GBS, immediate life-threatening assessments take priority:
Respiratory Function Monitoring
- Measure vital capacity, negative inspiratory force (NIF), and maximum inspiratory/expiratory pressures immediately and serially 3
- Apply the "20/30/40 rule": Patient is at risk of respiratory failure if vital capacity <20 ml/kg, maximum inspiratory pressure <30 cmH₂O, or maximum expiratory pressure <40 cmH₂O 3
- Single breath count ≤19 predicts need for mechanical ventilation 3
Autonomic Monitoring
- Perform electrocardiography and continuously monitor heart rate and blood pressure for arrhythmias and instability 3
- Dysautonomia is common and can include blood pressure or heart rate instability, pupillary dysfunction, and bowel or bladder dysfunction 1, 3
Common Pitfall
Do not delay treatment waiting for a non-existent "Expert Express GBS" protocol or test. The American Academy of Neurology recommends not waiting for antibody test results before starting treatment if GBS is suspected 3. Treatment with either IVIg (0.4 g/kg daily for 5 days) or plasma exchange (200-250 ml/kg for 5 sessions) should begin immediately in patients unable to walk unaided within 2-4 weeks of symptom onset 1, 2.