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Guideline
, 61 (6), 736-40

Practice Parameter: Immunotherapy for Guillain-Barré Syndrome: Report of the Quality Standards Subcommittee of the American Academy of Neurology

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Guideline

Practice Parameter: Immunotherapy for Guillain-Barré Syndrome: Report of the Quality Standards Subcommittee of the American Academy of Neurology

R A C Hughes et al. Neurology.

Abstract

Objective: To provide an evidence-based statement to guide physicians in the management of Guillain-Barré syndrome (GBS).

Methods: Literature search and derivation of evidence-based statements concerning the use of immunotherapy were performed.

Results: Treatment with plasma exchange (PE) or IV immunoglobulin (IVIg) hastens recovery from GBS. Combining the two treatments is not beneficial. Steroid treatment given alone is not beneficial.

Recommendations: 1) PE is recommended for nonambulant adult patients with GBS who seek treatment within 4 weeks of the onset of neuropathic symptoms. PE should also be considered for ambulant patients examined within 2 weeks of the onset of neuropathic symptoms; 2) IVIg is recommended for nonambulant adult patients with GBS within 2 or possibly 4 weeks of the onset of neuropathic symptoms. The effects of PE and IVIg are equivalent; 3) Corticosteroids are not recommended for the management of GBS; 4) Sequential treatment with PE followed by IVIg, or immunoabsorption followed by IVIg is not recommended for patients with GBS; and 5) PE and IVIg are treatment options for children with severe GBS.

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