Guillain Barre Syndrome (GBS) - Presentation and Diagnosis

What is GBS?

GBS is a post infective demyelinating neuropathy of unknown cause. it usually occurs one to three weeks after an episode of respiratory tract infection, diarrhoea, surgery or vaccination.GBS is a immunologically mediated disease.In most of the cases GBS follow an infection with CMV (Cytomegalovirus), mycoplasma or campylobacter jejuni. 

GBS

Presentation

A patient of GBS usually presents with the complaints of weakness of Lower limbs for few days and difficulty in walking for same duration.Flaccid type of paraplegia is seen in a patient of GBS. 

Important clinical examination findings in GBS

The higher cerebral function of patient of GBS is usually normal. All the cranial nerves are intact. The muscle tone of the Lower limbs of the patient is diminished but the muscle bulk of the patient is normal. The sensory function of the nerves are usually intact.The striking abnormality is seen in a GBS patient when the jerks of the patient are tested. The knee and the ankle jerks are often seen absent but the biceps and triceps jerks are normal.The jerks in the upper limbs may be absent in a patient of GBS in very advanced stage.

Investigations to diagnose GBS

A CSF study may be sufficient to declare GBS. Albuminocytological dissociation is found in the CSF of a GBS patient.(Albumin maybe found very high in the CSF of a GBS patient) But if the lymphocytes count is more than 50/cmm then GBS is unlikely.

Investigations to identify CMV, mycoplasma and campylobacter jejuni can be done.

Nerve condition study can be done and may show slow condition, condition block or demyelinating neuropathy.