neurologic disorders
Guillain Barré Syndrome (GBS)
Key Points
Guillain-Barré syndrome typically begins with an ascending, relatively symmetric flaccid weakness. Initially, distinguish other disorders that cause similar symptoms (eg, myasthenia gravis, botulism, tick paralysis, West Nile virus infection, metabolic neuropathies, transverse myelitis; outside the US, poliomyelitis) based on history and examination results. Do electrodiagnostic testing and CSF analysis, even though diagnosis is primarily clinical. Most patients improve considerably over a period of months, but about 30% of adults and even more children have some residual weakness at 3 year, and 2 to 5% develop chronic inflammatory demyelinating polyneuropathy. Intensive supportive care is key to recovery. Try IVIG first, then if it is ineffective, plasma exchange. 