Treatment dilemmas in Guillain-Barré syndrome

J Neurol Neurosurg Psychiatry. 2017 Apr;88(4):346-352. doi: 10.1136/jnnp-2016-314862. Epub 2016 Nov 11.

Abstract

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical course and outcome. Intravenous immunoglobulin (IVIg) and plasma exchange are proven effective treatments, but the efficacy has been demonstrated mainly on motor improvement in adults with a typical and severe form of GBS. In clinical practice, treatment dilemmas may occur in patients with a relatively mild presentation, variant forms of GBS, or when the onset of weakness was more than 2 weeks ago. Other therapeutic dilemmas may arise in patients who do not improve or even progress after initial treatment. We provide an overview of the current literature about therapeutic options in these situations, and additionally give our personal view that may serve as a basis for therapeutic decision-making.

Keywords: GUILLAIN-BARRE SYNDROME.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Disease Progression
  • Guillain-Barre Syndrome / therapy*
  • Humans
  • Immunization, Passive*
  • Neurologic Examination
  • Plasma Exchange*
  • Treatment Outcome