When should I consider referring a patient with Guillain-Barré Syndrome to a specialist for further management?

Consider referring a patient with Guillain-Barré Syndrome (GBS) to a specialist urgently if they have rapidly progressive symmetrical limb weakness developing within 4 weeks, especially if there is any evidence of bulbar or respiratory involvement. This includes adults presenting with rapidly progressive symmetrical limb weakness, as they require neurological assessment and evaluation of bulbar and respiratory function.

In children, refer urgently for neurological assessment if there are features suggesting motor impairment or if tingling is accompanied by other peripheral nervous system symptoms such as weakness, bladder, or bowel dysfunction. This is because tingling may be the first symptom of acute polyneuropathy like GBS.

Early specialist referral is critical to assess and manage potential respiratory failure and other complications associated with GBS.