Guillain-Barré Syndrome (GBS)

Guillain-Barre syndrome describes an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni).

• acute inflammatory polyradiculoneuropathy with resultant weakness and diminished reflexes (demyelinating neuropathy with ascending weakness)
• autoimmune damage of multiple peripheral nerves
• the most important cause of acute flaccid paralysis

Triggering Agents

• Campylobacter jejuni ( usually cause diarrhoea)
• CMV (2nd most common)
• EBV
• others: HIV, mycoplasma species
• ?Vaccination. >>> Influenza and Rabies

Features

Initial symptoms

• around 65% of patients experience back/leg pain in the initial stages of the illness
• Often followed after Gastroenteritis or URTISx

The characteristic features of Guillain-Barre syndrome is progressive, symmetrical weakness of all the limbs.

• the weakness is classically ascending i.e. the legs are affected first
• reflexes are reduced or absent
• sensory symptoms tend to be mild (e.g. distal paraesthesia) with very few sensory signs

Other features