Guillain-Barré Syndrome — RACP Adult Medicine MCQ

Correct answer: C — Admit for respiratory and autonomic monitoring and start IV immunoglobulin or plasma exchange

The best answer is “Admit for respiratory and autonomic monitoring and start IV immunoglobulin or plasma exchange”. The pattern is Guillain–Barré syndrome, and falling vital capacity creates an airway emergency. IV immunoglobulin and plasma exchange have comparable disease-modifying efficacy; combining them routinely adds no benefit. Corticosteroid monotherapy is ineffective, and autonomic instability can occur even when sensory symptoms are modest. The preceding infection is a trigger, not an ongoing cause reversed by antibiotics.

Reference: NSW Agency for Clinical Innovation: Neurology clinical resources: https://aci.health.nsw.gov.au/networks/neurology