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Table 1 Differentiation between CIP and GBS

From: Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

  CIP 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
  1. CIP: critical illness polyneuropathy; GBS: Guillain-Barré syndrome; ICU: intensive care unit; CSF: cerebrospinal fluid; MRI: magnetic resonance imaging.