Update of diagnosis and treatments in Guillain–Barré syndrome

Abstract

Guillain–Barré syndrome (GBS) is an acute, monophasic, immune–mediated polyneuropathy. International GBS guideline was published by European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) in 2023 and Japanese GBS guideline was also revised in 2024. These guidelines include novel findings from the International GBS Outcome Study (IGOS) which is a large, multicenter, international prospective observational study. The 2023 EAN/PNS diagnostic criteria for motor–sensory or motor GBS requires (1) progressive muscle weakness in the upper and lower extremities, (2) decline or loss of tendon reflexes in the affected limb, and (3) progression for no more than 4 weeks. In the diagnosis of GBS, it is important to differentiate other diseases including acute–onset chronic inflammatory demyelinating polyradiculoneuropathy (A–CIDP). Regarding immune treatment, the evidence for additional treatment after initial therapy is still lacking. However, the phase II clinical trials of imlifidase (IdeS) and ANX005 (anti–C1q antibody) as novel therapeutic candidates for GBS has already been completed. Future progress of these treatments for GBS is expected.