Diagnosis and management of Guillain–Barré syndrome in ten steps

Guillain–Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. 

https://doi.org/10.1038/s41582-019-0250-9

General: 

  • Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré syndrome. The Lancet. 2021; 397(10280): 1214-1228.
  • Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. The Lancet. 2016, 388(10045): 717-727.
  • Papri N, Islam Z, Leonhard SE, Mohammad QD, Endtz HP, Jacobs BC. Guillain–Barré syndrome in low-income and middle-income countries: challenges and prospects. Nature Reviews Neurology. 2021 May; 17(5): 285-96.

Publications related to the International GBS Outcome Study (IGOS)

  • Protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré Syndrome: https://pubmed.ncbi.nlm.nih.gov/28406555/

Treatment: 

  • Current treatment practice of Guillain-Barré syndrome: https://pubmed.ncbi.nlm.nih.gov/31175208/
  • Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study: https://pubmed.ncbi.nlm.nih.gov/31586949/
  • Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study: https://pubmed.ncbi.nlm.nih.gov/34103340/

Epidemiology: 

  • Regional variation of Guillain-Barré syndrome: https://pubmed.ncbi.nlm.nih.gov/30247567/
  • Guillain–Barré syndrome in Denmark: a population-based study on epidemiology, diagnosis and clinical severity: https://pubmed.ncbi.nlm.nih.gov/30536111/
  • Guillain-Barré syndrome after SARS-CoV-2 infection in an international prospective cohort study: https://pubmed.ncbi.nlm.nih.gov/34553216/
  • An International Perspective on Preceding Infections in Guillain-Barré Syndrome: The IGOS 1000-Cohort: https://pubmed.ncbi.nlm.nih.gov/35981895/

Prognostic models: 

  • Predicting Outcome in Guillain-Barré Syndrome: https://n.neurology.org/content/98/5/e518.long
  • International Validation of the Erasmus Guillain-Barré Syndrome Respiratory Insufficiency Score: https://pubmed.ncbi.nlm.nih.gov/35106830/
  • Modified Erasmus GBS Respiratory Insufficiency Score: a simplified clinical tool to predict the risk of mechanical ventilation in Guillain-Barré syndrome: https://pubmed.ncbi.nlm.nih.gov/36428088/

Electrodiagnosis: 

  • Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values: https://pubmed.ncbi.nlm.nih.gov/35078730/
  • Electrodiagnostic subtyping in Guillain-Barré syndrome: use of criteria in practice based on a survey study in IGOS: https://pubmed.ncbi.nlm.nih.gov/35700346/