Guillain Barre syndrome in MRCP

Guillain Barre syndrome in MRCP


There are only a few common neurology problems that are popular in MRCP. One of them is Guillain Barre syndrome and I think I will try to highlight some salient points about this condition.


First thing to remember about this condition is we always term any medical problem a syndrome when we do not understand fully about it.


GBS was first described in 1859 by Landry. Guillain Barre syndrome is a type of acute inflammatory demyelinating peripheral neuropathy mainly involving the motor modality.



Although it may involve sensory or autonomic modality, classically you will be given a question involving motor neuropathy in MRCP.


GBS is believed to result from autoimmune humoral- and cell-mediated responses to a recent infection or any of a long list of medical problems.


Second lesson to be learned if you are sitting for MRCP is patient with GBS usually come to the hospital after viral or bacterial infection. The common infections associated with GBS are Campylobacter jejuni , Haemophilus influenzae, Mycoplasma pneumoniae, and Borrelia burgdorferi and influenza. Therefore patients usually have gastrointestinal and respiratory illness before the onset of GBS.

Patient with unilateral foot drop

Patients usually come with ascending weakness and some of them may complain numbness over the extremities.The classical physical signs are bilateral foot drop with loss of reflexes. However, remember some rare variants involving cranial nerves may be seen ( Miller-Fisher),patients may present with facial weakness mimicking Bell palsy, dysphagia, dysarthria, ophthalmoplegia, and pupillary disturbances.


Patients with GBS will usually die because of autonomic dysfunction with cardiac dysrhythmias or respiratory muscle involvement.
How to diagnose GBS, you have to do lumbar puncture, classically you will find elevated CSF protein. However, you may want to do nerve conduction study ( a delay in F wave), if you are suspecting Miller-Fisher, anti-GQ1b may be present.
How to monitor your patient’s respiratory function, monitor their Forced vital capacity.


Treatment is giving IV Immunoglubulin!