Evolution of Guillain-Barré Syndrome: From Classical Descriptions to Modern Diagnostic and Therapeutic Concepts
TL;DR
Advances in serial nerve conduction studies and electrodiagnostic criteria have improved recognition and classification of atypical presentations, including reversible conduction failure, and Parallel developments in clinical assessment and prognostic tools have strengthened prediction of respiratory compromise and functional recovery.
Abstract
Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy with considerable clinical, electrophysiological, and immunological heterogeneity. Over the years, the understanding of GBS has evolved beyond the classical post-infectious demyelinating presentation to include axonal forms, nodopathies, anti-ganglioside antibody-associated syndromes, regional variants, and central nervous system-peripheral nervous system (CNS-PNS) overlap syndromes. Advances in serial nerve conduction studies and electrodiagnostic criteria have improved recognition and classification of atypical presentations, including reversible conduction failure. Parallel developments in clinical assessment and prognostic tools, particularly the Hughes disability score and the Erasmus GBS Respiratory Insufficiency Score (EGRIS), Erasmus GBS Outcome Score (EGOS), and modified EGOS (mEGOS), have strengthened prediction of respiratory compromise and functional recovery. Current management remains centred on intravenous immunoglobulin and plasma exchange, while targeted therapies including monoclonal antibodies are being investigated in clinical trials. Despite these advances, early diagnosis, accurate subclassification, and prognostication remain challenging, underscoring the need for a more individualised approach to management and continued exploration of disease-specific therapeutic strategies.