Guillain–Barré syndrome: “I may be weird, but i still can’t walk!”

Abstract

Guillain–Barré syndrome is a demyelinating disorder caused by antibodies that cross react with proteins in the myelin sheath and possibly a preceding infection. Symptoms are preceded by a URI or diarrhea in two-thirds of cases, and common infections include Campylobacter jejuni, CMV and Epstein-Barr virus, varicella-zoster virus, and Mycoplasma pneumoniae. It is characterized by an ascending paralysis with accompanying pain and paresthesias in most cases. Albuminocytologic dissociation may be seen in only 50% of cases of early GBS. Autonomic dysfunction is a dangerous complication and can cause rapid BP swings, profound bradycardia, and arrhythmias. The Miller Fisher syndrome involves primarily the head and neck, along with muscular incoordination, bulbar paralysis, and areflexia. Five percent of patients die from GBS, often from other medical complications (PE, sepsis, cardiac arrest, etc.). Treatment includes symptomatic care, prevention of medical complications, ventilatory support if needed, plasma exchange, and IVIG.