16. Practical Management of Guillain–Barré Syndrome and Myasthenic Crisis

  1. Edward M. Manno MD, FCCM, FAAN, FAHA
  1. Alejandro A. Rabinstein MD

Published Online: 11 APR 2012

DOI: 10.1002/9781118297162.ch16

Emergency Management in Neurocritical Care

Emergency Management in Neurocritical Care

How to Cite

Rabinstein, A. A. (2012) Practical Management of Guillain–Barré Syndrome and Myasthenic Crisis, in Emergency Management in Neurocritical Care (ed E. M. Manno), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118297162.ch16

Editor Information

  1. Neurological Intensive Care Unit Cleveland Clinic Cleveland, OH, USA

Author Information

  1. Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA

Publication History

  1. Published Online: 11 APR 2012
  2. Published Print: 11 MAY 2012

Book Series:

  1. Neurology in Practice

Book Series Editors:

  1. Robert A. Gross and
  2. Jonathan W. Mink

Series Editor Information

  1. Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

ISBN Information

Print ISBN: 9780470654736

Online ISBN: 9781118297162

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Keywords:

  • Neuromuscular;
  • respiratory failure;
  • Guillain–Barré syndrome;
  • myasthenia gravis;
  • mechanical ventilation;
  • BiPAP;
  • immunotherapy;
  • intravenous immunoglobulin;
  • plasma exchange;
  • autonomic dysfunction

Summary

Guillain–Barré syndrome and myasthenia gravis are the two most common causes of primary neuromuscular respiratory failure. Although these two conditions have similarities, such as their typically self-limited course and response to immunotherapy, they also have major differences. Guillain–Barré can have an acute presentation complicated by autonomic dysfunction. In these patients early intubation is necessary. Myasthenic patients initially present with fluctuating fatigue and may be successfully treated with noninvasive ventilation if this is initiated early in the course of the neuromuscular decline. This chapter provides practical information to guide the management of patients with Guillain-Barré syndrome and myasthenic crisis in the intensive care unit.