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Neurology. 2003 Sep 23;61(6):736-40.

Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology.

Author information

1
Department of Neuroimmunology, Guy's, King's and St. Thomas' School of Medicine, London, UK.

Abstract

OBJECTIVE:

To provide an evidence-based statement to guide physicians in the management of Guillain-Barré syndrome (GBS).

METHODS:

Literature search and derivation of evidence-based statements concerning the use of immunotherapy were performed.

RESULTS:

Treatment with plasma exchange (PE) or IV immunoglobulin (IVIg) hastens recovery from GBS. Combining the two treatments is not beneficial. Steroid treatment given alone is not beneficial.

RECOMMENDATIONS:

1) PE is recommended for nonambulant adult patients with GBS who seek treatment within 4 weeks of the onset of neuropathic symptoms. PE should also be considered for ambulant patients examined within 2 weeks of the onset of neuropathic symptoms; 2) IVIg is recommended for nonambulant adult patients with GBS within 2 or possibly 4 weeks of the onset of neuropathic symptoms. The effects of PE and IVIg are equivalent; 3) Corticosteroids are not recommended for the management of GBS; 4) Sequential treatment with PE followed by IVIg, or immunoabsorption followed by IVIg is not recommended for patients with GBS; and 5) PE and IVIg are treatment options for children with severe GBS.

PMID:
14504313
[Indexed for MEDLINE]

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