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Guillain-Barré Syndrome — RACP Paediatrics MCQ

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HardNeurology & DevelopmentGuillain-Barré SyndromeRACP Paediatrics

A 4-year-old girl presents with acute onset of ascending weakness over 2 days. She had a gastroenteritis illness 2 weeks ago. On examination, she has absent deep tendon reflexes and bilateral foot drop. Respiratory rate is 28/min. What is the most important immediate investigation?

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Correct answer: B — Forced vital capacity (FVC) measurement

This presentation is consistent with Guillain-Barré syndrome (GBS). While lumbar puncture (showing albuminocytological dissociation) and nerve conduction studies are important for diagnosis, the most important immediate assessment is respiratory function (FVC). An FVC <20 mL/kg indicates impending respiratory failure requiring ICU admission and possible ventilation. Bulbar function should also be assessed.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Guillain-Barré Syndrome