Guillain-Barre syndrome: features

Guillain-Barre syndrome describes an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni).

Initial symptoms

around 65% of patients experience back/leg pain in the initial stages of the illness

The characteristic features of Guillain-Barre syndrome is progressive, symmetrical weakness of all the limbs.

the weakness is classically ascending i.e. the legs are affected first
reflexes are reduced or absent
sensory symptoms tend to be mild (e.g. distal paraesthesia) with very few sensory signs

Other features

there may be a history of gastroenteritis
respiratory muscle weakness
cranial nerve involvement
- diplopia
- bilateral facial nerve palsy
- oropharyngeal weakness is common
autonomic involvement
- urinary retention
- diarrhoea

Less common findings

papilloedema: thought to be secondary to reduced CSF resorption

Investigations

lumbar puncture
- rise in protein with a normal white blood cell count (albuminocytologic dissociation) - found in 66%
nerve conduction studies may be performed
- decreased motor nerve conduction velocity (due to demyelination)
- prolonged distal motor latency
- increased F wave latency

Pathophysiology of Guillain-Barre syndrome

+PassMedicine Notes

Guillain-Barre syndrome describes an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni).

Initial symptoms

around 65% of patients experience back/leg pain in the initial stages of the illness

The characteristic features of Guillain-Barre syndrome is progressive, symmetrical weakness of all the limbs.

the weakness is classically ascending i.e. the legs are affected first
reflexes are reduced or absent
sensory symptoms tend to be mild (e.g. distal paraesthesia) with very few sensory signs

Other features