NINDS Diagnostic Criteria for Guillain Barre Syndrome Features Required for Guillain-Barré Syndrome: • Progressive muscle weakness of more than one limb • Areflexia or hyporeflexia Features Supportive of Diagnosis: • Progression of weakness for 2-4 weeks • Symmetric involvement, Mild sensory symptoms or signs, Cranial nerve involvement, Recovery begins 2-4 weeks after nadir, Autonomic dysfunction, Absence of fever, Elevated CSF protein Features Casting Doubt on Diagnosis: • Marked persistent asymmetry of weakness • Persistent bladder or bowel dysfunction, Severe bladder or bowel dysfunction at onset • >50 Leukocytes/mm3 in CSF, Presence of polymorphonuclear leukocytes in CSF • Sharp sensory level • Central nervous system signs except in Miller Fisher syndrome-Bickerstaff brainstem encephalitis spectrum disorders Features That Rule out Diagnosis • History of hexacarbon abuse • Acute intermittent porphyria • Recent diphtheritic infection • Poliomyelitis, botulism, toxic neuropathy, functional paralysis BWH Medicine Residency @BrighamMedRes #Guillain #Barre #Syndrome #diagnosis #criteria #neurology #neuropathy
