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Neurology


Answer 5
  1. Immunoglobulin, intravenously. Both immunoglobulin administered intravenously (IVIg) and plasmapheresis have demonstrated benefits in treating patients with GBS. Both treatments improve time to clinical recovery, defined as either discontinuing mechanical ventilation or regaining independent ambulation. IVIg should be given at a dosage of 0.4 g/kg daily for 5 days, and 4 or 5 plasma exchanges of 3.5 to 4 L can be performed on alternate days over a period of 1 to 2 weeks. Complications are more common with plasmapheresis (eg, hypotension, line sepsis) than with IVIg (eg, headaches, myalgias, fevers, chills). Administration of corticosteroids, antibiotics, pyridostigmine, and interferon beta has no proven therapeutic benefit in patients with GBS.

    SUGGESTED READINGS
    1.
     Pascuzzi RM, Fleck JD. Acute peripheral neuropathy in adults. Guillain-Barré syndrome and related disorders. Neurol Clin 1997;15:529-47.

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