Rapidly progressing paralysis and respiratory failure occur in 20–30% of patients. Some require mechanical ventilation within 48 hours.
Areflexia is a red flag for GBS in patients with rapidly progressive limb weakness.
A history of weakness preceded by respiratory or GI infection suggests GBS.
Host factors appear to play a role in GBS, but no clear genetic risk has been identified.
Infection of the respiratory (22–53%) or GI (6–26%) tract in preceding 6 weeks
Diagnostic criteria for typical GBS:
Differential diagnosis of acute flaccid paralysis:
Sural nerve biopsy not indicated except to rule out vasculitis or amyloidosis.
Emphasize expectation for significant recovery and explain phases of illness.
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