Clinical features and diagnosis of Guillain-Barré syndrome in adults
- Francine J Vriesendorp, MD
Francine J Vriesendorp, MD
- Professor of Neurology
- SUNY Upstate Medical University
- Section Editors
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
- Ira N Targoff, MD
Ira N Targoff, MD
- Section Editor — Muscle Disease
- Professor of Medicine, Section of Rheumatology
- University of Oklahoma Health Sciences Center
The acute immune-mediated polyneuropathies are classified under the eponym Guillain-Barré syndrome (GBS), after the authors of early descriptions of the disease. GBS is a heterogeneous condition with several variant forms. Most often, GBS presents as an acute monophasic paralyzing illness provoked by a preceding infection.
The clinical features and diagnosis of GBS in adults will be reviewed here. Other aspects of GBS are discussed separately. (See "Treatment and prognosis of Guillain-Barré syndrome in adults" and "Guillain-Barré syndrome in children: Epidemiology, clinical features, and diagnosis" and "Guillain-Barré syndrome in children: Treatment and prognosis".)
Guillain-Barré syndrome (GBS) occurs world-wide with an overall incidence of 1 to 2 per 100,000 per year [1,2]. While all age groups are affected, the incidence increases by approximately 20 percent with every 10-year increase in age beyond the first decade of life. In addition, the incidence is greater in males than in females.
The cardinal clinical features of Guillain-Barré syndrome (GBS) are progressive, fairly symmetric muscle weakness accompanied by absent or depressed deep tendon reflexes. Patients usually present a few days to a week after onset of symptoms. The weakness can vary from mild difficulty with walking to nearly complete paralysis of all extremity, facial, respiratory, and bulbar muscles.
Studies from the United States and Europe, reflecting primarily patients with acute inflammatory demyelinating polyneuropathy (AIDP), show that GBS is associated with the following clinical features :
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- CLINICAL FEATURES
- Laboratory features
- GBS VARIANTS
- Acute inflammatory demyelinating polyneuropathy
- Acute motor axonal neuropathy
- Acute motor and sensory axonal neuropathy
- Miller Fisher syndrome
- Bickerstaff encephalitis
- Pharyngeal-cervical-brachial weakness
- Other variants
- DIAGNOSTIC EVALUATION
- Cerebrospinal fluid analysis
- Clinical neurophysiology studies
- Diagnostic criteria
- DIFFERENTIAL DIAGNOSIS
- Chronic inflammatory demyelinating polyneuropathy
- Other polyneuropathies
- Spinal cord disorders
- Neuromuscular junction disorders
- Muscle disorders
- Differential diagnosis of Miller Fisher syndrome
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS