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Guillain-Barré Syndrome — RACP Adult Medicine MCQ

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EasyNeurologyGuillain-Barré SyndromeRACP Adult Medicine

A 50-year-old woman presents with bilateral lower limb weakness progressing over 2 weeks, areflexia, and distal paraesthesiae. Nerve conduction studies show demyelinating features. CSF shows albuminocytological dissociation. What is the most appropriate treatment?

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Correct answer: D — IV immunoglobulin (IVIg)

This presentation is classic for Guillain-Barré syndrome (GBS). IVIg (0.4 g/kg/day for 5 days) or plasma exchange are equally effective first-line treatments. Corticosteroids are NOT effective in GBS and may delay recovery. The choice between IVIg and plasma exchange depends on availability and patient factors. Serial FVC monitoring is essential as respiratory failure occurs in ~25%.

Reference: eTG – 2025 – Neurology; EAN/PNS – 2023 – GBS Guidelines