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Guillain-Barre syndrome — RCPSC IM MCQ

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HardNeurologyGuillain-Barre syndromeRCPSC IM

A patient with myasthenia gravis develops weak cough, dysphagia, neck flexion weakness and forced vital capacity 16 mL/kg during pneumonia. What is the next step?

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Correct answer: A — Begin ventilatory support planning and IVIG or plasma exchange

The best answer is “Begin ventilatory support planning and IVIG or plasma exchange”. Bulbar weakness and falling vital capacity indicate myasthenic crisis with imminent ventilatory failure. Early ICU monitoring, airway planning and rapid immunomodulation are required; excess pyridostigmine increases secretions, magnesium worsens transmission, and hypercapnia is a late sign.

Reference: Canadian Blood Services, therapeutic apheresis. https://professionaleducation.blood.ca/en/transfusion/clinical-guide/therapeutic-apheresis