Fast Five Quiz: Guillain-Barré Syndrome Practice Essentials

Helmi L. Lutsep, MD


December 06, 2022

Early diagnosis and treatment of GBS can be important to long-term prognosis, especially in patients with poor clinical prognostic signs. These include antecedent diarrhea as well as older age and a rapidly progressing course. A study by Anandan and colleagues indicated that autonomic dysfunction among hospitalized patients with GBS most frequently manifests as diarrhea/constipation (15.5%), hyponatremia (14.9%), syndrome of inappropriate antidiuretic hormone secretion (4.8%), bradycardia (4.7%), and urinary retention (3.9%).

Cranial nerve involvement is common and may be observed in as many as 75% of patients with GBS. Recovery occurs in the vast majority, and their presence is not strongly associated with worse outcomes. Cranial nerves III-VII and IX-XII may be affected. Common symptoms include:

  • Facial droop (may mimic Bell palsy)

  • Diplopia

  • Dysarthria

  • Dysphagia

  • Ophthalmoplegia

  • Pupillary disturbances

Patients with persistent functional impairments may need to be transferred to an inpatient rehabilitation unit. Continued care also is needed to reduce problems related to immobility, and early involvement of allied health staff is recommended.

Learn more about the prognosis of GBS.


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