A 25-year-old man presents with ascending weakness over 2 weeks, areflexia, and autonomic instability. CSF shows albumino-cytological dissociation. Nerve conduction studies show prolonged F-wave latencies and reduced CMAP amplitudes. Which treatment is MOST appropriate?
- A High-dose methylprednisolone
- B IV immunoglobulin (IVIg) or plasmapheresis ✓
- C Pyridostigmine
- D Cyclophosphamide
Correct answer: B. IV immunoglobulin (IVIg) or plasmapheresis
Explanation
Guillain-Barré syndrome (GBS) management includes IVIg (0.4 g/kg/day × 5 days) or plasma exchange, which are equally effective and can shorten duration of mechanical ventilation and improve outcome. Corticosteroids are NOT effective in GBS and may even worsen outcome — multiple RCTs including the Dutch GBS trial confirmed no benefit. Pyridostigmine is for myasthenia gravis. Cyclophosphamide is not used in GBS.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.