A type of polyradiculo-neuropathy

Etiology

• Demyelinating autoimmune condition
• Post-infection
  • Campylobacter jejuni → Most common
  • CMV (HHV5)
  • Zika virus
  • HIV
  • EBV (HHV 4)
• Rarely:
  • Post surgery
  • Post immunization (flu vaccine)
  • Trauma

Classification

• Umbrella term with different subtypes
• Most common subtype: AIDP

Presentation

• Onset: acute (< 2 mon)
• Time course: symptom MUST plateau in 4 wks
• Motor pre-dominant, but can have sensory symptom
  • Rapidly progressing, symmetric distal and proximal limb Muscle Weakness, varing in severity between mild to near complete paralysis
  • LMN signs: Hyporeflexia/areflexia *may takes wks to develop, but almost everyone with GBS has it
  • mild Paresthesia
  • Facial weakness/paralysis → CN involvement
• Severe complications
  • !Respiratory Failure
  • Dysphagia
  • Autonimic dysfunction
    • ↑ Tachycardia (>150)
    • Diarrhea or Constipation
    • Urinary retention

DDx

• CIP - Critical Illness Polyneuropathy : more common in ICU
• !Compressive Cervical Myelopathy
• CIDP → a chronic subtype

Investigation

• EMG/NCS → Can be normal early on