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Guillain-Barré syndrome with respiratory risk — SCE Acute Medicine MCQ

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HardNeurology and ophthalmologyGuillain-Barré syndrome with respiratory riskSCE Acute Medicine

A 55-year-old woman presents with progressive ascending weakness two weeks after diarrhoea. Reflexes are absent and forced vital capacity is 16 mL/kg. She has difficulty coughing and oxygen saturations are 96% on air. What is the most appropriate next step in management?

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Correct answer: A — Admit to a monitored setting with urgent neurology and critical care review

Guillain-Barré syndrome can cause rapidly progressive respiratory muscle failure despite normal oxygen saturation. A forced vital capacity of 16 mL/kg is concerning and warrants monitored care with critical care involvement. Corticosteroids are not effective first-line disease-modifying therapy; IVIG or plasma exchange is considered with neurology input.

Reference: NICE CKS Guillain-Barré syndrome; Association of British Neurologists Guidance