Key Learning Points

GBS is a spectrum of diseases affecting both the axon and myelin sheath.
A post-infectious presentation is common, particularly Campylobacter Jejuni gastroenteritis.
Typical GBS presents with rapidly progressive symmetrical ascending weakness and reduced or absent reflexes.
Presentation may be subtle, especially in children, with pain, gait disturbance, or refusal to walk. GBS should be considered in the differential diagnosis of the limping child.
Fever at presentation, raised CSF white cell count (WCC), atypical features, or relevant travel history should prompt consideration of alternative diagnoses.
All suspected cases should be referred for admission
ICU care may be required for patients with significant respiratory problems
ECG and blood pressure monitoring are required
Severe cases should be treated with IVIG
Corticosteroids have no proven benefit in GBS.
Prognosis in children is generally very good