Guillain-Barre Syndrome: The Daily PANCE Blueprint

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Guillain-Barré Syndrome: The Daily PANCE Blueprint

A 45-year-old man has 5 days of ascending symmetric weakness with absent reflexes after a diarrheal illness; CSF shows high protein with a normal cell count, and spirometry is being trended. What is the most appropriate treatment?

A. High-dose intravenous corticosteroids
B. Intravenous immunoglobulin (IVIG) or plasmapheresis
C. Pyridostigmine
D. Intravenous acyclovir
E. Oral gabapentin alone

Answer and topic summary

The answer is B. Intravenous immunoglobulin (IVIG) or plasmapheresis.

Guillain-Barre syndrome is treated with either IVIG or plasmapheresis (equally effective and not combined). Corticosteroids do not help – a classic board trap. Pyridostigmine treats myasthenia gravis; acyclovir treats HSV; and gabapentin only addresses neuropathic pain. The priority alongside treatment is serial spirometry / forced vital capacity, because respiratory failure is the leading cause of death.

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Covered under ⇒ PANCE Blueprint Neurology ⇒ Peripheral Nerve Disorders ⇒ Guillain-Barré Syndrome

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