Treatment Options
The treatment options for GBS are detailed below.
Monitoring
- Lung function initially every four hours
- ECG
- BP
- Autonomic function – pupils and ileus
- Check for swallowing dysfunction
General measures
- Pain relief: try to avoid opioids
- Chronic neuropathic pain: amitriptyline or antiepileptic drugs
- DVT prophylaxis
- Eye care
- Meticulous nursing to avoid pressure sores
- Physiotherapy to avoid contractures
- Consider early ICU admission for severely affected patients
Indications for ICU admission
- Risk of aspiration pneumonia
- Requiring ventilated support
- Rapidly-progressive disease
- Labile heart rate or blood pressure
Specific treatments
- IVIG or PE for those unable to walk, ideally to start within two weeks of onset of symptoms
- Typical IVIG regimen: 0.4g/kg for five days
- Typical PE regimen: total exchange of five plasma volumes in two weeks
- Retreatment with IVIG may be indicated if there is a secondary deterioration