Electrolytes in GBS

Q: Which electrolyte disturbance is more common in patients with Guillain-Barré syndrome (GBS) who develop dysautonomia?

A) Hypernatremia

B) Hyponatremia

Answer: B

Dysautonomia is a dreaded side effect in GBS, which may occur in a large population of these patients. These patients are usually sicker, requiring hospitalization, more cardiogenic events, a higher disability, and mortality, including sudden death.

Hyponatremia is very common and may be a direct effect or attributed to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which occurs due to autonomic involvement.

The other usual symptoms are ileus, hyper- and/or hypotension, fever, tachycardia and/or bradycardia, and urinary retention.

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

3. Saifudheen K, Jose J, Gafoor VA, Musthafa M. Guillain-Barre syndrome and SIADH. Neurology 2011; 76:701.