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Guillain–Barré Syndrome, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Group of peripheral nerve disorders characterized by autoimmune demyelination and axonal degeneration of peripheral nerves leading to acute ascending paralysis

  • Humoral and cellular im...

Diagnosis

Signs and Symptoms

History

  • Rapidly evolving, symmetric, ascending paralysis

  • Absent or mild sensory symptoms (e.g., paresthesias of fingertips or toes)

  • Pain, commonly of pelvis, shoulder girdles,...

Treatment

Pre-Hospital

Attention to airway management 

Initial Stabilization/Therapy

Airway assessment and management: 
  • Progression to respiratory failure can be rapid

Ed Treatment/Procedures

  • Airway managem...

Follow-Up

Disposition

Admission Criteria

  • All patients with GBS or suspected GBS warrant admission for close observation

  • ICU admission for those with signs of respiratory compromise, autonomic dysfunction...

Pearls and Pitfalls

  • Pearls:

    • Check FVC and/or NIF frequently to anticipate airway compromise

    • Consider other etiologies if CSF WBC count >10–50

  • Pitfalls:

    • Failure to obtain appropriate imaging of the brai...

Additional Reading

  • Brettschneider  J, Petzold  A, Süssmuth  S, et al. Cerebrospinal fluid biomarkers in Guillain-Barré syndrome–where do we stand? J Neurol.  2009;256:3–12.

  • Hughes  RA, Swan  AV, R...

Codes

ICD9

357.0 Acute infective polyneuritis 

ICD10

G61.0 Guillain-Barre syndrome 

SNOMED

  • 40956001 Guillain-Barre syndrome (disorder)

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