• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (35)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Neuromuscular diseases  • Pain  • Immunologic Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

Richard A. C. Hughes, MD; Eelco F. M. Wijdicks, MD; Estelle Benson; David R. Cornblath, MD; Angelika F. Hahn, MD; Jay M. Meythaler, MD; John T. Sladky, MD; Richard J. Barohn, MD; James C. Stevens, MD

Arch Neurol. 2005;62:1194-1198.

A multidisciplinary consensus group searched MEDLINE from 1966 to May 2003, extracted relevant references, and prepared recommendations on supportive care for Guillain-Barré syndrome. In the absence of randomized controlled trials, we agreed on recommendations by consensus based on observational studies and expert opinion. In the acute phase in bed-bound adult patients, the group recommended the use of heparin and graduated pressure stockings to prevent deep vein thrombosis, monitoring for blood pressure, pulse, autonomic disturbances, and respiratory failure, and the timely institution of artificial ventilation and tracheostomy. Pain management is difficult, but carbamazepine or gabapentin may help. The cautious use of narcotic analgesics may be needed. Disabled patients should be treated by a multidisciplinary rehabilitation team and should receive an assistive exercise program. Persistent fatigue following Guillain-Barré syndrome is common and may be helped by an exercise program. Because of a very small and possibly only theoretical increase in the risk of recurrence following immunization, the need for immunization should be reviewed on an individual basis. More research is needed to identify optimal methods for all aspects of supportive care.

Author Affiliations: Department of Clinical Neuroscience, King’s College, London, England (Dr Hughes); Department of Neurology, Mayo Clinic, Rochester, Minn (Dr Wijdicks); Guillain-Barré Syndrome Foundation International, Wynnewood, Pa (Mrs Benson); Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Cornblath); London Health Sciences Center, London, Canada (Dr Hahn); Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham (Dr Meythaler); Division of Neurology, Emory University School of Medicine, Atlanta, Ga (Dr Sladky); Department of Neurology, University of Kansas Medical Center, Kansas City (Dr Barohn); and Fort Wayne Neurological Center, Fort Wayne, Ind (Dr Stevens).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

24.16 Diseases of the peripheral nerves
Hughes and Thomas
OTM 2011;5:med-9780199204854-chapter-med-9780199204854-chapter.
ABSTRACT | FULL TEXT  

Unusual manifestation of dengue fever
Chaudhary et al.
BMJ Case Reports 2011;2011:bcr0220113839-bcr0220113839.
ABSTRACT | FULL TEXT  

Inpatient Management of Guillain-Barre Syndrome
Harms
The Neurohospitalist 2011;1:78-84.
ABSTRACT | FULL TEXT  

A Clinical Picture of Guillain-Barre Syndrome in Children in the United States
Hicks et al.
J Child Neurol 2010;25:1504-1510.
ABSTRACT  

Management of acute respiratory failure in restrictive disorders (obesity excluded)
Winck and Goncalves
Noninvasive Ventilation 2010;1:37-46.
ABSTRACT  

An integrated care pathway for Guillain-Barre syndrome in children
Lakin et al.
Intl J Care Pathw 2010;14:70-75.
ABSTRACT | FULL TEXT  

Chapter 16 Acute pain in the neurological patient
Chong and Ganesalingham
OPML Acute Pain 2010;1:med-9780199234721-chapter-med-9780199234721-chapter.
ABSTRACT | FULL TEXT  

Diagnosis and treatment in inflammatory neuropathies
Lunn and Willison
Postgrad. Med. J. 2009;85:437-446.
ABSTRACT | FULL TEXT  

Diagnosis and treatment in inflammatory neuropathies
Lunn and Willison
J. Neurol. Neurosurg. Psychiatry 2009;80:249-258.
ABSTRACT | FULL TEXT  

Chapter 2 The clinical approach
Donaghy
Brain's Diseases of the Nervous System 2009;12:med-9780198569381-chapter-med-9780198569381-chapter.
ABSTRACT | FULL TEXT  

Chapter 21 Polyneuropathy
Donaghy
Brain's Diseases of the Nervous System 2009;12:med-9780198569381-chapter-med-9780198569381-chapter.
ABSTRACT | FULL TEXT  

Guillain-Barre syndrome
Winer
BMJ 2008;337:a671-a671.
FULL TEXT  

Guillain-Barre syndrome
Waldmann et al.
ODR Nephrology 2008;1:med-9780199229581-div1-17-med-9780199229581-div1-17.
FULL TEXT