Guillain-Barré Syndrome

Occurs in both sexes, all races, all ages, but mostly affects young and middle-aged adults.

Worldwide illness and occurs at all times of the year.

Mortality rate is 3–7%; most pts eventually fully recover and 20% have significant residual weakness.

Resp failure secondary to polyneuropathy

Autonomic dysfunction with profound CV instability

Rapidity of symptoms; respiratory paralysis may occur within 24 h of onset

Pulm complications

Polyneuropathy often encountered in critical care practice.

Pts present initially with lower limb weakness that ascends.

Widespread, patchy, inflammatory demyelination of peripheral and autonomic nervous systems.

Dysautonomia occurs from chromatolysis of antero-mediolateral cell column and autonomic ganglia: Fluctuating BP, Htn, hypotension, postural hypotension, tachycardia, and arrhythmias.

CSF protein is usually normal during first few days of illness and steadily rises and remains elevated for several months, even after recovery.

Evidence points to infection-induced autoimmune response.

Typically antecedent illness occurs within 4 wk of onset, with respiratory or GI infection ( Campylobacter jejuni ) in 60–70% of cases.

Other predisposing factors incl surgery, pregnancy, malignancy, and acute seroconversion to HIV.

Epidural or spinal anesthesia may be antecedent to the event or associated with recurrence.