Journal
NATURE REVIEWS NEUROLOGY
Volume 15, Issue 11, Pages 671-683Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/s41582-019-0250-9
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Funding
- European Union [734584]
- Wellcome Trust Foundation
- Prinses Beatrix Spierfonds
- GBS/CIDP Foundation International
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico
- Prinses Beatrix Foundation
- Ministry of Education, Culture, Sports, Science and Technology of Japan [18H02745]
- Ministry of Health, Labour and Welfare of Japan
- Malaysian Ministry of Education [FP043-2018A]
- ALS Association
- National Health and Medical Research Council of Australia
- Grants-in-Aid for Scientific Research [18H02745] Funding Source: KAKEN
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Guillain-Barre syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.
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