Clinical Features

• Back and limb pain

• Paresthesias affecting distal extremities

• Ascending paralysis

  • Bilateral flaccid paralysis

  • Spreads from the lower to the upper limbs in a “stocking‑glove” distribution

• Landry paralysis: involvement of the respiratory muscles → respiratory failure

• Muscle reflexes

  • Reduced or absent

  • Commonly beginning in the lower limbs

• Paresthesias

  • Peripheral, symmetric

  • Usually affecting hands and feet

• Neuropathic pain: develops in about ⅔ of affected individuals

• Autonomic dysfunction

  • Cardiovascular

    • Arrhythmia

    • Blood pressure dysregulation: ↑ or ↓

  • Voiding dysfunction

  • Intestinal dysfunction

• Cranial nerve involvement

  • Facial diplegia due to frequent bilateral facial nerve involvement

  • Also affects glossopharyngeal nerve (IX) and vagal nerve (X)

GBS paralysis affects the muscles of respiration, possibly leading to death due to respiratory failure.