Guillain-Barré syndrome in adults: Clinical features and diagnosis
- 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 "Guillain-Barré syndrome in adults: Treatment and prognosis" and "Guillain-Barré syndrome in children: Epidemiology, clinical features, and diagnosis" and "Guillain-Barré syndrome in children: Treatment and prognosis".)
The pathogenesis of Guillain-Barré syndrome (GBS) is reviewed here briefly and discussed in detail elsewhere. (See "Guillain-Barré syndrome: Pathogenesis".)
GBS is thought to result from an immune response to a preceding infection that cross-reacts with peripheral nerve components because of molecular mimicry. The immune response can be directed towards the myelin or the axon of peripheral nerve, resulting in demyelinating and axonal forms of GBS. (See "Guillain-Barré syndrome: Pathogenesis", section on 'Mechanisms'.)
Campylobacter jejuni infection is the most commonly identified precipitant of GBS. Cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus (HIV), and Zika virus have also been associated with GBS. (See "Guillain-Barré syndrome: Pathogenesis", section on 'Antecedent events'.)
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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
- Electrodiagnostic 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