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.