Overview
Guillain-Barré syndrome (GBS) is an acute, rapidly progressive autoimmune disorder characterized by symmetrical weakness and sensory dysfunction due to peripheral nerve demyelination and axonal damage 123.Diagnosis
Clinical presentation includes progressive muscle weakness, often ascending from the legs, and may involve cranial nerve involvement 12.
Electrophysiological studies (nerve conduction studies and electromyography) show demyelination and axonal damage 1.
Cerebrospinal fluid analysis typically reveals albuminocytologic dissociation (elevated protein levels with normal cell count) 12.
Diagnostic criteria include acute onset of weakness, absence of fever, and characteristic electrophysiological findings 1.Management
First-line treatment: Intravenous immunoglobulin (IVIG) 0.4 g/kg/day for 5 days or plasmapheresis 14.
Adjunctive therapies: Supportive care including mechanical ventilation for respiratory failure, pain management, and monitoring for complications such as autonomic dysfunction 1.Special Populations
Pediatrics: GBS can occur in children following infections like dengue, though less commonly reported 3.
Vaccine-associated GBS: Increased risk noted post-influenza and other vaccinations, particularly within 6 weeks post-vaccination 24.
Elderly: Higher susceptibility to severe forms of GBS, requiring vigilant monitoring and supportive care 1.Key Recommendations
Monitor and report GBS post-vaccination, especially following influenza and other vaccines, within 6 weeks post-exposure (Evidence: Moderate 24).
Initiate IVIG or plasmapheresis early in the course of GBS for optimal outcomes (Evidence: Moderate 14).
Provide comprehensive supportive care including respiratory support and pain management to manage symptoms and complications (Evidence: Expert opinion 1).References
1 Finsterer J, Zarrouk S. SARS-CoV-2-Associated<br /> Guillain-Barre Syndrome<br /> is Common but Under-<br /> recognised and Under-<br /> reported. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2023. link
2 Souayah N, Nasar A, Suri MF, Qureshi AI. Guillain-Barre syndrome after vaccination in United States a report from the CDC/FDA Vaccine Adverse Event Reporting System. Vaccine 2007. link
3 Sulekha C, Kumar S, Philip J. Guillain-Barre syndrome following dengue fever. Indian pediatrics 2004. link
4 Geier MR, Geier DA, Zahalsky AC. Influenza vaccination and Guillain Barre syndrome. Clinical immunology (Orlando, Fla.) 2003. link00046-9)