Guillain-Barre Syndrome
GBS is a generalized peripheral disorder that can be confused with several other conditions. The diagnosis is based upon the typical clinical features, an electrodiagnostic examination, and examination of the cerebrospinal fluid. It is useful to determine the specific subtype that the patient is suffering from since the axonal forms (AMAN and AMSAN) tend to have a poorer prognosis.
The only clinical feature that is required for the diagnosis of GBS is progressive weakness in both arms and both legs. The progression of the typical symptoms over days to 4 weeks, the relative symmetry of the symptoms, the presence of mild sensory symptoms, and symptoms indicative of cranial nerve involvement and/or autonomic dysfunction strongly support the diagnosis of GBS.
If a diagnosis of botulism, myasthenia, poliomyelitis, or toxic neuropathy is made; if abnormal porphyrin metabolism is noted; if there is a history of recent diphtheria; or if a purely sensory syndrome without weakness is observed, then GBS can possibly be ruled out. There are distinct features of the various types of GBS; these are listed in Table 2.
Diagnosis
GBS is a generalized peripheral disorder that can be confused with several other conditions. The diagnosis is based upon the typical clinical features, an electrodiagnostic examination, and examination of the cerebrospinal fluid. It is useful to determine the specific subtype that the patient is suffering from since the axonal forms (AMAN and AMSAN) tend to have a poorer prognosis.
The only clinical feature that is required for the diagnosis of GBS is progressive weakness in both arms and both legs. The progression of the typical symptoms over days to 4 weeks, the relative symmetry of the symptoms, the presence of mild sensory symptoms, and symptoms indicative of cranial nerve involvement and/or autonomic dysfunction strongly support the diagnosis of GBS.
If a diagnosis of botulism, myasthenia, poliomyelitis, or toxic neuropathy is made; if abnormal porphyrin metabolism is noted; if there is a history of recent diphtheria; or if a purely sensory syndrome without weakness is observed, then GBS can possibly be ruled out. There are distinct features of the various types of GBS; these are listed in Table 2.
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