Guillain-Barré syndrome history and symptoms

Patients with Guillain Barre syndrome may have a positive history of: Prior infection with Campylobacter jejuni, Cytomegalovirus, Haemophilus influenzae, Epstein-Barr virus, Varicella zoster virus and HIV-1, recent vaccination with influenzae or rabies vaccine, limb tingling and paresthesia, lower extremity weakness and muscle pain.

Common symptoms of Guillain Barre syndrome include: Symmetrical ascending weakness and paralysis, tingling and paresthesia and pain.

• Patients with Guillain Barre syndrome may have a positive history of:
  • Prior infection such as:
    • Campylobacter jejuni:^[1]
      • gastroenteritis
    • Cytomegalovirus:^[2]
      • Respiratory infection, mononucleosis and flu-like symptoms.
    • Haemophilus influenzae^[3]
    • Epstein-Barr virus
      • Mononucleosis
    • Varicella zoster virus^[4]
      • Chicken pox
    • HIV-1^[5]
  • Recent vaccination:^[6][7]
    • Influenza vaccine
    • Rabies vaccine
  • Limb tingling and paresthesia
  • Lower extremity weakness^[8]
  • muscle pain^[9]

Common symptoms of Guillain Barre syndrome include:

• Most of Guillain Barre syndrome cases can be diagnosed based on partially symmetrical ascending weakness and paralysis.
• Can cause sensory symptoms such as tingling and paresthesia.^[8]
• Because of nerve inflammation, in the acute phase of GBS patients complain of pain.^[9]
• Some of the features may be specific to different subgroups of GBS.
  • Acute inflammatory demyelinating polyneuropathy:^[10](4)
    • It affects lower extremities first and then involves upper extremities, trunk, neck and cranial nerves.
    • It can involve sensory neurons.
    • Deep sensation is the most affected sense.
    • It causes areflexia
    • In AIDP we may see autonomic involvement such as changes in heart rate and blood pressure and urinary retention.
  • Acute motor axonal neuropathy/Acute motor and sensory axonal neuropathy:^[11][12]
    • Can causes hyperreflexia.
    • Autonomic dysfunction in absent or mild.
    • AMSAN can causes severe type of GBS with slow recovery
  • Miller Fisher syndrome^[13]
    • This type of GBS causes ophthalmoplegia.
    • The reflexes are absence.
    • There is gait abnormalities (Ataxia).

Less common symptoms of Guillain Barre syndrome include:

• Symptoms of papilledema such as
  • Headache
  • Visual disturbance^[14]
• Involuntary facial movement (facial myokymia)^[15]
• Hearing loss^[16]
• Difficulty speaking (vocal cord paralysis)^[17]
• Mental status changes^[18]

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