Guillain–Barré syndrome (GBS)

(aka: Landry–Guillain–Barré–Strohl syndrome:

	Most common cause of acute flaccid paralysis

	Rapidly progressive ascending paralysis & areflexia

	Autonomic dysfunction, CSF albumin-cytologic dissociation.

	The sensory and motor systems may be equally affected. 

	The paralysis moves rapidly from lower to upper areas.



Differential diagnosis:

	Myasthenia gravis: Intermittent & worsened by exertion.

	Multiple Sclerosis: CNS demyelination, hyperreflexia, multiple lesions on MRI, oligoclonal bands in CSF.

	Botulism: Descending weakness fixed dilated pupils, food/wound toxin exposure & prominent cranial nerve dysfunction with normal sensation.

	Tick paralysis: Ascending paralysis but spares sensation.

	West Nile virus: Headache, fever, & asymmetric flaccid paralysis but spares sensation.

	Transverse myelitis: Pain, weakness, abnormal sensation, urinary dysfunction, sensory level, hyperreflexia, spinal cord lesion on MRI.

	CIDP: Chronic progression, relapses, requires long-term immunotherapy.

	Spinal Cord Compression: Hyperreflexia, sensory level, MRI shows mass or compression.

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