Guillain-Barre syndrome describes an immune-mediated ascending demyelination of the peripheral nervous system

Causes

• Typically 1-3 weeks after infection (e.g. Campylobacter, mycoplasma, EBV)
• 40% of cases are idiopathic.

PC

Initial symptoms:

• around 65% of patients experience back/leg pain in the initial stages of the illness

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

• there may be a history of gastroenteritis
• respiratory muscle weakness in severe cases
• cranial nerve involvement
  • diplopia
  • bilateral facial nerve palsy
  • oropharyngeal weakness is common
• autonomic involvement
  • urinary retention
  • diarrhoea