Autoimmune neuropathies: New guidelines and expert insights into clinical decision making

Guillain-Barré syndrome (GBS) and chronic demyelinating polyneuropathy (CIDP) are immune-mediated demyelinating neuropathies that may have similar symptoms in their early stages. GBS is generally monophasic with acute, progressive, flaccid paralysis of the extremities accompanied by reduced/absent reflexes. The onset of GBS is often 1-2 weeks after a precipitating event and reaches its nadir by 4 weeks. With CIDP the progressive phase by definition lasts more than 2 months, although it can be shorter in acute-onset forms which initially resemble GBS.

In this review, the diagnostic criteria and treatment options from recent European Academy of Neurology (EAN)/Peripheral Nerve Society (PNS) guidelines for GBS and CIDP and current literature will be discussed addressing basic and advanced diagnostics, differential diagnoses, antecedent events, risk factors and therapeutic options.

The guidelines can assist with evidence-based diagnosis and treatment of GBS and CIDP by providing critically evaluated, well-documented evidence to support clinical decisions. Individualized diagnostic and therapeutic approaches are warranted due to heterogenous patient populations and disease presentations.