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Guillain-Barré syndrome — SCE Neurology MCQ

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HardNeuromuscularGuillain-Barré syndromeSCE Neurology

Ten days after diarrhoea, a patient develops ascending weakness, bilateral facial paresis, areflexia and autonomic instability. CSF has raised protein with few cells and nerve conduction shows demyelination. What is the diagnosis?

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Correct answer: E — Acute inflammatory demyelinating polyradiculoneuropathy, the common Guillain–Barré subtype, clinically

The best answer is “Acute inflammatory demyelinating polyradiculoneuropathy, the common Guillain–Barré subtype, clinically”. The acute monophasic ascending demyelinating polyradiculoneuropathy after infection is classic GBS; respiratory and autonomic monitoring are urgent. “Chronic inflammatory demyelinating polyneuropathy” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Polymyositis” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Miller Fisher syndrome” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Small-fibre neuropathy” is a credible alternative elsewhere, but it fails the decisive discriminator in this case.

Reference: NICE CG145 suspected neurological conditions recommendations: https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-adults-aged-over-16