Guillain-Barre Syndrome
-
What are the signs and symptoms of Guillain-Barré syndrome (GBS) manifesting as an acute inflammatory polyradiculoneuropathy?
-
@laisy The typical patient with GBS, which in most cases will manifest as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), presents 2-4 weeks following a relatively benign respiratory or gastrointestinal illness with complaints of finger dysesthesias and proximal muscle weakness of the lower extremities. The weakness may progress over hours to days to involve the arms, truncal muscles, cranial nerves, and muscles of respiration.
Common complaints associated with cranial nerve involvement in GBS include the following:
Facial droop (may mimic Bell palsy)
Diplopias
Dysarthria
Dysphagia
Ophthalmoplegia
Pupillary disturbances
Most patients complain of paresthesias, numbness, or similar sensory changes. Paresthesias generally begin in the toes and fingertips, progressing upward but generally not extending beyond the wrists or ankles.
Pain associated with GBS is most severe in the shoulder girdle, back, buttocks, and thighs and may occur with even the slightest movements. The pain is often described as aching or throbbing in nature.
Autonomic changes in GBS can include the following:
Tachycardia
Bradycardia
Facial flushing
Paroxysmal hypertension
Orthostatic hypotension
Anhidrosis and/or diaphoresis
Urinary retention
Typical respiratory complaints in GBS include the following:
Dyspnea on exertion
Shortness of breath
Difficulty swallowing
Slurred speech
Ventilatory failure with required respiratory support occurs in up to one third of patients at some time during the course of their disease.