Practical approach to the patient with acute neuromuscular weakness

Table 2 Diagnostic criteria for Guillain-Barré syndrome

Features required for diagnosis

Progressive weakness in both arms and legs

Areflexia or hyporeflexia

Features that strongly support the diagnosis

Progressive motor weakness up to 4 wk

Relative symmetry of symptoms

Mild sensory involvement

Cranial nerve involvement, especially bilateral facial

Weakness

Autonomic dysfunction

Pain

Albuminocytological dissociation in CSF

Electrodiagnostic features of demyelination

Features that should raise doubt about the diagnosis

Respiratory failure with limited weakness of limbs at onset

Severe sensory signs at onset

Bladder or bowel dysfunction at onset and persistence of dysfunction in the disease course

Fever at onset

Sharp sensory level

Slow progression with limited weakness without

Respiratory involvement

Persistent asymmetry of motor weakness

Mono/polymorphonuclear leukocytosis in CSF

Adapted from Asbury et al[14]. CSF: Cerebrospinal fluid.