Guillain-Barré Syndrome: Current Understanding, Diagnostic Approaches, and Therapeutic Advances

Abstract:

Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy characterized by rapidly progressive, symmetrical weakness with areflexia. This review examines the epidemiology, pathophysiology, clinical presentations, diagnostic approaches, and current therapeutic strategies for GBS. We discuss the immunological mechanisms underlying GBS, including molecular mimicry between microbial and peripheral nerve antigens, and analyze the clinical spectrum of GBS variants. The global incidence is 1-2 per 100,000 person-years with a male predominance and bimodal age distribution. Approximately two-thirds of cases are preceded by infection, with Campylobacter jejuni being the predominant cause. The clinical spectrum encompasses several variants, including Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN), and Miller Fisher Syndrome. Diagnosis relies on clinical features, cerebrospinal fluid analysis revealing albuminocytological dissociation, and electrodiagnostic studies. Current treatment includes intravenous immunoglobulin and plasma exchange, along with comprehensive supportive care. Despite advances, 20-30% of patients experience significant long-term disability. This review integrates existing evidence with a focus on recent advances in pathophysiologic understanding, diagnostic techniques, and management approaches, while highlighting areas for future research. Keywords: Guillain-Barré Syndrome, molecular mimicry, Acute Inflammatory Demyelinating Polyneuropathy (AIDP), intravenous immunoglobulin, electrodiagnostic studies.

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