Pathology: Autoimmune mediated acuteinflammatory demyelinating polyneuropathy resulting in ascending motorparalysis, sensory symptoms and loss of deep tendon reflexes
Aetiology: History of preceding viralor diarrheal illness – Associated with campylobacter jejuni
Symptoms: Ascending motor weaknessusually starting in the lower limbs and altered sensation.
Signs: Paresthesia,areflexia, cranial nerve palsies, symptoms of dysautonomia such as fluctuatingBP, temperature, heart rate
Respiratory muscleweakness can occur in severe cases
Investigations: Bloods: Serology for virusessuch as EBV, CMV, HIV and Anti-ganglioside antibodies
LumbarPuncture: Increased CSF protein with low cell count
Stool Culture: Screenfor Campylobacter Jejuni
Other: Nerveconduction studies
Treatment: Medical: Intravenous immunoglobulins,Plasma exchange and rehabilitation
Monitoring: Cardiac and regularlung function tests
Admission: ITU and ventilationfor respiratory compromise
Complications: Cardiac arrhythmias, respiratoryarrest, LRTI
Prognosis: Majority of patients recoverfully
5-10% left with significantdisability.
Poor prognosis is associatedwith elderly, significant disability at 2 weeks, history of preceding diarrheaand significant abnormality in nerve conduction studies. Recurrence of GBS isvery rare.
