Sodium and GBS

Q: Which of the following is a poor prognostic sign in Guillain-Barre Syndrome (GBS)?

A) hyponatremia

B) hypernatremia

Answer: A

There are two related clinical conditions that may bear poor prognosis in GBS - dysautonomia, and syndrome of inappropriate antidiuretic hormone secretion (SIADH). Both conditions can lead to hyponatremia.

Dysautonomia results in ileus, blood pressure, heart rate variations, fever, urinary retention, and sudden death. Autonomic involvement may also cause SIAH.

#neurology

References:

1. Chakraborty T, Kramer CL, Wijdicks EFM, Rabinstein AA. Dysautonomia in Guillain-Barré Syndrome: Prevalence, Clinical Spectrum, and Outcomes. Neurocrit Care 2020; 32:113.

2. Zochodne DW. Autonomic involvement in Guillain-Barré syndrome: a review. Muscle Nerve 1994; 17:1145.

3. Anandan C, Khuder SA, Koffman BM. Prevalence of autonomic dysfunction in hospitalized patients with Guillain-Barré syndrome. Muscle Nerve 2017; 56:331.