The acute immune-mediated polyneuropathies are classified under the eponym Guillain-Barré syndrome (GBS), after the authors of early descriptions of the disease. Guillain-Barré syndrome 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 "Overview of Guillain-Barré syndrome in children" and "Treatment of Guillain-Barré syndrome in children".)
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 :