Guillain-Barré Syndrome Emergency Management

Introduction to GBS

• Guillain-Barré Syndrome is a potentially fatal immune-mediated disease with a mortality rate of 3-10% even with the best medical care available, according to the American Academy of Neurology 1, 3
• Disease progression can be rapid, with most patients reaching maximum disability within 2 weeks of symptom onset, as noted by the American Academy of Neurology 1, 2

Critical Complications

• Approximately 20% of patients develop respiratory failure requiring mechanical ventilation, which can occur rapidly and sometimes without obvious symptoms of dyspnea, as reported by the American Thoracic Society 2, 4
• Cardiac arrhythmias and blood pressure instability from autonomic nervous system involvement can be life-threatening, according to the American Heart Association 1, 5

Treatment Approach

• Early treatment with immunotherapy (within the first 2 weeks) is associated with better outcomes, as recommended by the American Academy of Neurology 4, 6
• Intravenous immunoglobulin (IVIg) at 0.4 g/kg/day for 5 days (total dose 2 g/kg) or plasma exchange are first-line treatments, as suggested by the American Society for Apheresis 4

Long-term Considerations

• About 60-80% of patients are able to walk independently 6 months after disease onset, according to the American Academy of Neurology 1
• Treatment-related fluctuations occur in 6-10% of patients within 2 months of initial improvement, as noted by the American Academy of Neurology 4, 6