SAQ 131 – Neurology – Guillain-Barre syndrome and multiple sclerosis

Review Completed

Marked out of 18.00

Complete the table to distinguish between the historical features of Guillain-Barre syndrome and multiple sclerosis.

(Marked out of 4.0)

Historical feature	Guillain-Barre syndrome	Multiple sclerosis
1.
2.
3.
4.

/ 4

Complete the table to distinguish between the examination features of Guillain-Barre syndrome and multiple sclerosis.

(Marked out of 4.0)

Examination feature	Guillain-Barre syndrome	Multiple sclerosis
1.
2.
3.
4.

/ 4

List the two (2) investigations of choice to assist with the diagnosis of multiple sclerosis. State two (2) diagnostic findings that are supportive of multiple sclerosis for each investigation.

(Marked out of 6.0)

Investigation of choice	Supportive finding 1	Supportive finding 2
1.
2.

/ 6

Assuming the diagnosis of Guillain-Barre syndrome, which drug must not be given if intubation is required? State the reason why.

(Marked out of 2.0)

/ 2

List the two (2) options for specific treatment of Guillain-Barre syndrome.

(Marked out of 2.0)

/ 2

Total Score: 0 / 18

Percentage: 0%

History	Guillain-Barre syndrome	Multiple sclerosis
Age at onset	Typical onset 20-40 years old	Onset often 30-40 years old; female predominance.
Onset	Post-infection, symptoms, immunisation, or malignancy	Insidious; episodic, relapsing and remitting.
Distribution	Ascending motor paralysis; glove and stocking sensory loss	Random distribution; eyes often first.
Limb pain	Passive movement or calf pain common	Electric shock sensations in legs, worse with neck flexion.
Visual disturbance	Ophthalmoplegia rare	Optic neuritis, painful eye movements, visual acuity or field defects.
Cerebral features	Usually normal mental state	Intellectual decline or seizures may occur.
Natural course	>90% recovery; stabilise and improve	Progressive or relapsing-remitting course.

Examination	Guillain-Barre syndrome	Multiple sclerosis
Cranial nerves	Facial nerve or bulbar involvement in about 50%	Common, especially eye findings such as optic neuritis and RAPD.
Cerebellar signs	Rare	May be present.
Gait	Weakness	Spastic gait.
Tone	Decreased	Increased, clonus.
Reflexes	Decreased or flaccid LMN pattern	Increased UMN pattern.
Autonomic	Common	Rare; sensory or bladder dysfunction may occur.
Respiratory compromise	Reduced FEV1 and respiratory support may be required	Rare.

Investigation	Supportive findings
CSF examination	<10 cells/mL with T-lymphocyte predominance; normal protein; increased IgG or oligoclonal bands.
MRI brain	Subcortical and periventricular plaques; enhancement indicates activity and may resolve with remission.

← Previous SAQ Next SAQ →