Which specific CSF finding distinguishes Guillain-Barré syndrome from acute transverse myelitis when both present with acute ascending weakness?

• A Neutrophilic pleocytosis in GBS
• B Normal protein with lymphocytic pleocytosis in GBS
• C Xanthochromia in GBS, normal in ATM
• D Albuminocytological dissociation (high protein, normal cell count) in GBS ✓

Explanation

GBS characteristically shows albuminocytological dissociation — elevated CSF protein (often >45 mg/dL) with a normal or near-normal cell count (<10 cells/mm³). This occurs due to nerve root inflammation without meningeal involvement. In acute transverse myelitis, CSF typically shows lymphocytic pleocytosis with mildly elevated or normal protein, reflecting parenchymal inflammation. Neutrophilic pleocytosis would suggest bacterial infection. Xanthochromia indicates subarachnoid haemorrhage.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.