Patient handout

Guillain-Barré Syndrome — AIDP (classic demyelinating)

PRODUCTION

1. Your condition

This handout is for guillain-barré syndrome — aidp (classic demyelinating). Your care team identified this based on: classic ascending symmetric areflexic weakness + glove-and-stocking paresthesia (brighton 2011 pmid 24163275).

Other reasons your team may use this plan: preceding infection 1-6 wk prior (campylobacter / cmv / ebv / mycoplasma / zika) (van doorn 2011 pmid 25023340); ncs demyelinating pattern: segmental slowing + conduction block + prolonged distal latencies + temporal dispersion + reduced f-wave persistence (van doorn 2011 pmid 25023340); bulbar weakness with dysphagia / dysarthria / choking (aan 2012).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
ivig	0.4 g/kg/d × 5 d (total 2 g/kg)	IV	daily × 5 d	Hughes Cochrane 2014 PMID 25238327 — IVIG and PLEX equivalent within 2 wk; check IgA pre-IVIG (EAN/PNS 2023)
plasmapheresis (PLEX)	5 sessions over 7-10 d (q48h)	IV	5 sessions q48h	Raphael Cochrane PMID 22786475 — PLEX equivalent to IVIG; do NOT combine (Hughes Cochrane 2014)

Plan: AIDP — IVIG/PLEX + respiratory support + supportive bundle (Hughes Cochrane 2014 PMID 25238327; EAN/PNS 2023)

3. When to call your provider

Contact your care team if any of the following happen:

Worsening / new weakness >8 wk → CIDP workup (van Doorn 2011)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Classic AIDP — symmetric ascending areflexic weakness + glove-and-stocking paresthesia + preceding infection 1-6 wk; demyelinating NCS pattern (Brighton 2011 PMID 24163275; van Doorn 2011 PMID 25023340)
Bulbar weakness with dysphagia / dysarthria / choking — aspiration risk + airway compromise (AAN 2012)
Respiratory failure — FVC <20 mL/kg OR NIF magnitude <30 cmH2O OR severe bulbar weakness; ~1/3 AIDP need MV (AAN 2012; Walgaard 2009 PMID 20517939)(life-threatening)
Paroxysmal bradycardia/tachycardia + BP swings >40 mmHg + ileus + urinary retention; ~70% AIDP have autonomic dysfunction (IGOS Doets 2018 PMID 30247567)
Rapid progression to nadir within 24-48 h OR loss of ambulation within 7 d of onset → high ventilation risk (IGOS Doets 2018 PMID 30247567)
AIDP during pregnancy — IVIG preferred over PLEX (logistic + fetal monitoring); MFM consultation + delivery planning (EAN/PNS 2023)
Pediatric AIDP (typically 4-10 y) — same IVIG dose 0.4 g/kg/d × 5 d; consider weight-based dosing precision; PLEX possible but technically harder in small children (EAN/PNS 2023)

5. Follow-up

Neuro rehab, vaccine-delay advice, CIDP surveillance (>8 wk recurrence), psychology (NICE 2024)

6. Sources

Guideline: 2023 EAN/PNS GBS Diagnosis & Treatment Guideline + Hughes Cochrane 2014 IVIG + Brighton 2011 (Sejvar) + van den Berg/van Doorn 2014 Nat Rev Neurol