Guillain-Barré Syndrome — SCE Neurology MCQ

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EasyPeripheral Neuropathy & NeuromuscularGuillain-Barré SyndromeSCE Neurology

A 60-year-old man with Guillain-Barré syndrome is admitted with progressive weakness. He is now unable to walk independently. His FVC is 2.8 L (predicted 4.0 L). What is the most appropriate treatment?

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Correct answer: D — Intravenous immunoglobulin 0.4 g/kg/day for 5 days

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

Intravenous immunoglobulin (IVIg) at 0.4 g/kg/day for 5 days is first-line treatment for GBS in patients who cannot walk independently (Hughes grade ≥3). Plasma exchange is an equally effective alternative. Corticosteroids have no proven benefit in GBS and should not be used. A/C: Steroids are not effective in GBS. D: Azathioprine is not used in GBS. E: Observation alone is inappropriate given functional impairment and declining FVC.

Reference: ABN GBS Guidelines; EAN/PNS GBS Guidelines (2023)