GBS presents occasionally to ED as paediatric or adult weakness. Key components of the clinical picture include
-varying degrees of lower limb weakness ( sometimes presenting as new onset ‘cannot walk’), LMN signs in ascending pattern -usually mostly motor, but some sensory deficit -decreased or equivocal reflexes - dysautonomia (fluctuations in hr bp diaphoresis ) - respiratory failure with chest wall muscle weakness Remember to check FVC (<15L/kg) and FIP (<-25 cmh2o) as indicators for intubation and mechanical ventilation. Avoid suxamethonium and optimize vitals with short acting vasoactive agents ( esmolol if hypertensive, noradrenaline if hypotensive) prior to RSI.
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