Treatment

• Supportive management

  • Monitor cardiac and respiratory function: in some cases, intensive care unit (ICU) treatment and intubation may be indicated

  • Prevent decubitus ulcer and/or thrombosis (esp. pulmonary embolism)

• Intravenous immunoglobulins [12]

• Plasmapheresis

  • In adults: equivalent outcome as IV immunoglobulins

  • In children: only recommended in children with rapidly progressing or severe disease

Although GBS is considered an autoimmune disease, glucocorticoids are not recommended for treatment. They have not shown to hasten recovery or affect the long-term outcome. The only exception is the CIDP variant of GBS.

• ∼ 70% of patients with GBS have a good prognosis [13]

  • Disease progression peaks 2–4 weeks after the onset of symptoms.

  • Symptoms then recede in reverse order of their development (i.e., the last symptoms to appear resolve first, as Schwann cells remyelinate peripheral nerve axons).

• 3–7% of patients with GBS die due to acute complications such as:

  • Respiratory paralysis (apnea)

  • Pulmonary infection/embolism

  • Cardiac dysfunction

• 6 months after onset, ∼ 20% of affected individuals are still unable to walk unaided.

Death can occur as many as > 30 days after onset of symptoms, during the recovery phase.