Overview of the treatment of acute Guillain-Barré syndrome

GBS: Guillain-Barré syndrome; IVIG: intravenous immune globulin; PLEX: plasma exchange; CIPD: chronic inflammatory demyelinating polyneuropathy.
* Refer to the UpToDate topic on the pathogenesis, clinical features, and diagnosis of GBS in adults, section on diagnostic criteria.
¶ Monitoring includes at least daily neurologic examinations, respiratory monitoring typically every 2 to 4 hours, and continuous telemetry monitoring. Supportive care includes management of respiratory failure, hemodynamic and autonomic dysfunction, deep vein thrombosis prophylaxis, and pain control. More frequent evaluations are indicated for patients with severe deficits and those who are rapidly deteriorating. Refer to the UpToDate topic on the treatment of GBS for additional details.
Δ The selection of either agent depends upon local protocols, availability, patient preference, risk factors, and contraindications. IVIG is easier to administer.
◊ Includes patients who clinically worsen, show no improvement, or show transient improvement.
§ Treatment-related fluctuations include patients with clinical worsening after transient improvement after immunomodulatory therapy.
¥ Refer to the UpToDate topic on the pathogenesis, clinical features, and diagnosis of GBS in adults, section on differential diagnosis.