ICU SAQs · Neurocritical care / neuromuscular
Guillain-Barré syndrome — diagnosis and ICU management
A CICM SAQ on Guillain-Barré syndrome — diagnosis with CSF and electrophysiology, ICU admission and elective intubation by the 20/30/40 rule, IVIg or plasma exchange (EAN/PNS 2023), and autonomic and supportive care.
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Prompt
A 45-year-old presents with a 5-day history of ascending leg weakness, now involving the arms, after Campylobacter gastroenteritis. Vital capacity is 18 mL/kg and maximum inspiratory pressure 25 cmH2O. Outline the diagnosis and ICU management.
Question
A 45-year-old presents with a 5-day history of ascending leg weakness, now involving the arms, after Campylobacter gastroenteritis. Vital capacity is 18 mL/kg and maximum inspiratory pressure 25 cmH2O. Outline the diagnosis and ICU management.[1]
References7ShowHide
- [1]Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps Nat Rev Neurol, 2019.PMID 31541214
- [2]Lawn ND, Fletcher DD, Henderson RD, et al. Anticipating mechanical ventilation in Guillain-Barré syndrome Arch Neurol, 2001.PMID 11405803
- [3]van Doorn PA, Van den Bergh PYK, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain-Barré syndrome Eur J Neurol, 2023.PMID 37814552
- [4]Fokke C, van den Berg B, Drenthen J, et al. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria Brain, 2014.PMID 24163275
- [5]Wijdicks EF, Roy TK BiPAP in early Guillain-Barré syndrome may fail Can J Neurol Sci, 2006.PMID 16583732
- [6]Hor JY Cardiac arrhythmia after succinylcholine administration in a patient with Guillain-Barré syndrome--a case report Middle East J Anaesthesiol, 2010.PMID 21526679
- [7]Lawn ND, Wijdicks EF Tracheostomy in Guillain-Barré syndrome Muscle Nerve, 1999.PMID 10417787