Diagnosis and management of Guillain-Barre syndrome

摘要

Guillain-Barre syndrome (GBS) is an acute demyelinating disease of peripheral nerves, which usually follows a viral illness or immunisation. It is the commonest peripheral neuropathy to affect children, presenting with acute flaccid weakness which typically develops peripherally and which may ascend to involve respiratory muscles and cranial nerves. Autonomic dysfunction may occur. Pain in back and limbs is a common feature.There is considerable evidence that GBS is an immune-mediated disease. An association between antiganglioside antibodies and GBS has raised the possibility that certain infections lead to an immune response that cross-reacts with neural antigens.Careful attention to symptomatic treatment, with monitoring of vital signs, tube feeding and ventilatory support if necessary has led to an improvement in prognosis. GBS also appears to be ameliorated by immune modulating treatments such as plasmapheresis and intravenous immunoglobulins. Corticosteroids have not been shown to confer any benefit.