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Guillain-Barré Syndrome
Lubdha M. Shah, MD; Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Guillain-Barré syndrome (GBS)
            • Synonyms

              • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP)
              • "Ascending paralysis"
            • Definitions

              • Autoimmune postinfectious or postvaccinial acute inflammatory demyelination of peripheral nerves, nerve roots, cranial nerves

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nonvascular Interventions

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Dalakas MC: Pathogenesis of immune-mediated neuropathies. Biochim Biophys Acta. ePub, 2014
                                            2. Sung JY et al: Early identification of 'acute-onset' chronic inflammatory demyelinating polyneuropathy. Brain. ePub, 2014
                                            3. Barbay M et al: Clinically silent posterior reversible encephalopathy in Guillain-Barre syndrome. Can J Neurol Sci. 40(2):267, 2013
                                            4. Pietrini V et al: Miller Fisher syndrome with positivity of anti-GAD antibodies. Clin Neurol Neurosurg. 115(8):1479-81, 2013
                                            5. Topcu Y et al: Coexistence of myositis, transverse myelitis, and Guillain Barré syndrome following Mycoplasma pneumoniae infection in an adolescent. J Pediatr Neurosci. 8(1):59-63, 2013
                                            6. Rigamonti A et al: Posterior reversible encephalopathy syndrome as the initial manifestation of Guillain-Barré syndrome: case report and review of the literature. J Peripher Nerv Syst. 17(3):356-60, 2012
                                            7. Zuccoli G et al: Redefining the Guillain-Barré spectrum in children: neuroimaging findings of cranial nerve involvement. AJNR Am J Neuroradiol. 32(4):639-42, 2011
                                            8. van Doorn PA et al: IVIG treatment and prognosis in Guillain-Barré syndrome. J Clin Immunol. 30 Suppl 1:S74-8, 2010
                                            9. McCombe PA et al: Studies of HLA associations in male and female patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). J Neuroimmunol. 180(1-2):172-7, 2006
                                            10. Chang YW et al: Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome. Pediatr Radiol. 33(11):791-3, 2003
                                            11. Cheng BC et al: Guillain-Barre syndrome in southern Taiwan: clinical features, prognostic factors and therapeutic outcomes. Eur J Neurol. 10(6):655-62, 2003
                                            12. Haber P et al: Influenza vaccination and Guillain Barre syndrome. Clin Immunol. 109(3):359; author reply 360-1, 2003
                                            13. Molinero MR et al: Epidemiology of childhood Guillain-Barre syndrome as a cause of acute flaccid paralysis in Honduras: 1989-1999. J Child Neurol. 18(11):741-7, 2003
                                            14. Oh SJ et al: Subacute inflammatory demyelinating polyneuropathy. Neurology. 61(11):1507-12, 2003
                                            15. Kehoe M: Guillain-Barre syndrome--a patient guide and nursing resource. Axone. 22(4):16-24, 2001
                                            16. Wilmshurst JM et al: Lower limb and back pain in Guillain-Barre syndrome and associated contrast enhancement in MRI of the cauda equina. Acta Paediatr. 90(6):691-4, 2001
                                            17. Berciano J: MR imaging in Guillain-Barre syndrome. Radiology. 211(1):290-1, 1999
                                            18. Duarte J et al: Hypertrophy of multiple cranial nerves and spinal roots in chronic inflammatory demyelinating neuropathy. J Neurol Neurosurg Psychiatry. 67(5):685-7, 1999
                                            19. Wilmshurst JM et al: Familial Guillain-Barre syndrome. Eur J Neurol. 6(4):499-503, 1999
                                            20. Byun WM et al: Guillain-Barre syndrome: MR imaging findings of the spine in eight patients. Radiology. 208(1):137-41, 1998
                                            21. Vroomen PC et al: The clinical significance of gadolinium enhancement of lumbar disc herniations and nerve roots on preoperative MRI. Neuroradiology. 40(12):800-6, 1998
                                            22. Iwata F et al: MR imaging in Guillain-Barre syndrome. Pediatr Radiol. 27(1):36-8, 1997
                                            23. Gorson KC et al: Prospective evaluation of MRI lumbosacral nerve root enhancement in acute Guillain-Barre syndrome. Neurology. 47(3):813-7, 1996
                                            24. Bertorini T et al: Contrast-enhanced magnetic resonance imaging of the lumbosacral roots in the dysimmune inflammatory polyneuropathies. J Neuroimaging. 5(1):9-15, 1995
                                            25. Perry JR: MRI in Guillain-Barre syndrome. Neurology. 45(5):1024-5, 1995
                                            26. Crino PB et al: Magnetic resonance imaging of the cauda equina in Guillain-Barré syndrome. Neurology. 44(7):1334-6, 1994
                                            27. Georgy BA et al: MR of the spine in Guillain-Barre syndrome. AJNR Am J Neuroradiol. 15(2):300-1, 1994
                                            28. Jinkins JR et al: MRI of benign lumbosacral nerve root enhancement. Semin Ultrasound CT MR. 14(6):446-54, 1993
                                            29. Patel H et al: MRI of Guillain-Barre syndrome. J Comput Assist Tomogr. 17(4):651-2, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Guillain-Barré syndrome (GBS)
                                                      • Synonyms

                                                        • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP)
                                                        • "Ascending paralysis"
                                                      • Definitions

                                                        • Autoimmune postinfectious or postvaccinial acute inflammatory demyelination of peripheral nerves, nerve roots, cranial nerves

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nonvascular Interventions

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Dalakas MC: Pathogenesis of immune-mediated neuropathies. Biochim Biophys Acta. ePub, 2014
                                                                                      2. Sung JY et al: Early identification of 'acute-onset' chronic inflammatory demyelinating polyneuropathy. Brain. ePub, 2014
                                                                                      3. Barbay M et al: Clinically silent posterior reversible encephalopathy in Guillain-Barre syndrome. Can J Neurol Sci. 40(2):267, 2013
                                                                                      4. Pietrini V et al: Miller Fisher syndrome with positivity of anti-GAD antibodies. Clin Neurol Neurosurg. 115(8):1479-81, 2013
                                                                                      5. Topcu Y et al: Coexistence of myositis, transverse myelitis, and Guillain Barré syndrome following Mycoplasma pneumoniae infection in an adolescent. J Pediatr Neurosci. 8(1):59-63, 2013
                                                                                      6. Rigamonti A et al: Posterior reversible encephalopathy syndrome as the initial manifestation of Guillain-Barré syndrome: case report and review of the literature. J Peripher Nerv Syst. 17(3):356-60, 2012
                                                                                      7. Zuccoli G et al: Redefining the Guillain-Barré spectrum in children: neuroimaging findings of cranial nerve involvement. AJNR Am J Neuroradiol. 32(4):639-42, 2011
                                                                                      8. van Doorn PA et al: IVIG treatment and prognosis in Guillain-Barré syndrome. J Clin Immunol. 30 Suppl 1:S74-8, 2010
                                                                                      9. McCombe PA et al: Studies of HLA associations in male and female patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). J Neuroimmunol. 180(1-2):172-7, 2006
                                                                                      10. Chang YW et al: Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome. Pediatr Radiol. 33(11):791-3, 2003
                                                                                      11. Cheng BC et al: Guillain-Barre syndrome in southern Taiwan: clinical features, prognostic factors and therapeutic outcomes. Eur J Neurol. 10(6):655-62, 2003
                                                                                      12. Haber P et al: Influenza vaccination and Guillain Barre syndrome. Clin Immunol. 109(3):359; author reply 360-1, 2003
                                                                                      13. Molinero MR et al: Epidemiology of childhood Guillain-Barre syndrome as a cause of acute flaccid paralysis in Honduras: 1989-1999. J Child Neurol. 18(11):741-7, 2003
                                                                                      14. Oh SJ et al: Subacute inflammatory demyelinating polyneuropathy. Neurology. 61(11):1507-12, 2003
                                                                                      15. Kehoe M: Guillain-Barre syndrome--a patient guide and nursing resource. Axone. 22(4):16-24, 2001
                                                                                      16. Wilmshurst JM et al: Lower limb and back pain in Guillain-Barre syndrome and associated contrast enhancement in MRI of the cauda equina. Acta Paediatr. 90(6):691-4, 2001
                                                                                      17. Berciano J: MR imaging in Guillain-Barre syndrome. Radiology. 211(1):290-1, 1999
                                                                                      18. Duarte J et al: Hypertrophy of multiple cranial nerves and spinal roots in chronic inflammatory demyelinating neuropathy. J Neurol Neurosurg Psychiatry. 67(5):685-7, 1999
                                                                                      19. Wilmshurst JM et al: Familial Guillain-Barre syndrome. Eur J Neurol. 6(4):499-503, 1999
                                                                                      20. Byun WM et al: Guillain-Barre syndrome: MR imaging findings of the spine in eight patients. Radiology. 208(1):137-41, 1998
                                                                                      21. Vroomen PC et al: The clinical significance of gadolinium enhancement of lumbar disc herniations and nerve roots on preoperative MRI. Neuroradiology. 40(12):800-6, 1998
                                                                                      22. Iwata F et al: MR imaging in Guillain-Barre syndrome. Pediatr Radiol. 27(1):36-8, 1997
                                                                                      23. Gorson KC et al: Prospective evaluation of MRI lumbosacral nerve root enhancement in acute Guillain-Barre syndrome. Neurology. 47(3):813-7, 1996
                                                                                      24. Bertorini T et al: Contrast-enhanced magnetic resonance imaging of the lumbosacral roots in the dysimmune inflammatory polyneuropathies. J Neuroimaging. 5(1):9-15, 1995
                                                                                      25. Perry JR: MRI in Guillain-Barre syndrome. Neurology. 45(5):1024-5, 1995
                                                                                      26. Crino PB et al: Magnetic resonance imaging of the cauda equina in Guillain-Barré syndrome. Neurology. 44(7):1334-6, 1994
                                                                                      27. Georgy BA et al: MR of the spine in Guillain-Barre syndrome. AJNR Am J Neuroradiol. 15(2):300-1, 1994
                                                                                      28. Jinkins JR et al: MRI of benign lumbosacral nerve root enhancement. Semin Ultrasound CT MR. 14(6):446-54, 1993
                                                                                      29. Patel H et al: MRI of Guillain-Barre syndrome. J Comput Assist Tomogr. 17(4):651-2, 1993