See: [[Weakness]] - acute, acquired, inflammatory *demyelinating polyradiculoneuropathy* (**AIDP**) caused by autoimmune attack on peripheral nerves/nerve roots - most common cause of acute progressive generalised weakness in the ED - often precedes diarrhoea illness, especially *Campylobacter jejuni*. CMV is second most common infection associated with GBS. EBV, mycoplasma pneumoniae, [[HIV]], and h flu also associated # clinical features - progressive ascending weakness with loss of deep tendon reflexes - proximal and distal limb muscles are involved, as well as truncal and respiratory muscles - cranial nerve involvement is common, with facial nerve palsy occuring in up to 70% of cases - sensory symptoms are variable; paraesthesias and severe pain in some patients - autonomic dysregulation occurs in some patients, can be fatal due to severe fluctuations in BP and cardiac arrhythmias # investigations - [[Lumbar puncture]]: CSF findings of ==high CSF protein and normal glucose and cell count.== - mild CS pleuocytosis is common, however presence of CSF leucocytosis should promot careful consideration of alternative dxs such as lymphoma or HIV # complications - respiratory failure if phrenic nerve involvement - [[FVC]] of 10-12 mL/kg (<30% of predicted) is generally considered to be an indication for intubation and assisted ventilation (also for myasthenia gravis; normal FVC is 60-70) - paCO2 > 50 also may indicated intubation - do NOT use sux - NIV is not recommended for GBS, especially if there is significant bulbar weakness # treatment - IVIG - 2g/kg - plasmapheresis maybe - do NOT use steroids