Which of the following constellation of signs on examination is the most consistent with a diagnosis of Guillain-Barre Syndrome?


#1

A 45-year-old male presents to the acute medical take with a three day history of progressive bilateral leg weakness. Which of the following constellation of signs on examination is the most consistent with a diagnosis of Guillain-Barre Syndrome?

Bradycardia with lower limb hyporeflexia and flaccid paralysis
Tachycardia with lower limb hyporeflexia and spastic paralysis
Bradycardia with lower limb hyperreflexia and spastic paralysis
Tachycardia with lower limb hyporeflexia and flaccid paralysis
Tachycardia with lower limb hyperreflexia and flaccid paralysis

Dr. Kasper:
Tachycardia with lower limb hyporeflexia and flaccid paralysis

Absent or depressed deep tendon reflexes are classical findings in Guillain-Barre Syndrome (GBS). Hyperreflexia is seen in a GBS variant known as Bickerstaff’s encephalitis.

The paralysis in GBS is flaccid.

Autonomic symptoms are common in GBS. The most frequently encountered are tachycardia and urinary retention. Although autonomic dysfunction may manifest as hypertension, hypotension, bradycardia, or ileus, these are not as commonly seen.