Table 1 Differentiation between CIP and GBS

Prodromal conditions

Sepsis, multiple organ failure, etc.

Gastrointestinal or respiratory infection

Clinical presentation

Onset of the disorder usually after ICU admission;

Onset of the disorder usually before ICU admission;

Often be characterized by fairly symmetric limb muscle weakness sparing cranial nerves;

Infections precede the onset of progressive weakness and sensory disturbances;

Sensory deficits less prominent

Frequent cranial nerve involvement

CSF

Usually normal

Albumino-cytologic dissociation

Electrophysiology

Axonal motor & sensory polyneuropathy

1. Demyelinating polyneuropathy or unresponsive nerves, abundant spontaneous activity

2. Axonal motor & sensory polyneuropathy

MRI

No significant findings

Occasional enhancement of spinal nerve roots

Biopsy

Primarily axonal degeneration of distal peripheral nerves without inflammation

Primarily demyelinating process with inflammation, or motor/sensory axonal degeneration, or motor axonal degeneration only

Treatment

No specific therapy, usually anti-septic treatment

Plasmapheresis, intravenous immune globulin

Outcome

Recovery may be spontaneous and of variable timing; 50% of patients with full recovery

Usually >75% complete recovery