Guillain–Barré and Miller Fisher syndromes—new diagnostic classification

  • A Corrigendum to this article was published on 07 October 2014

Abstract

Guillain–Barré syndrome (GBS) and its variant, Miller Fisher syndrome (MFS), exist as several clinical subtypes with different neurological features and presentations. Although the typical clinical features of GBS and MFS are well recognized, current classification systems do not comprehensively describe the full spectrum of either syndrome. In this Perspectives article, GBS and MFS are classified on the basis of current understanding of the common pathophysiological profiles of each disease phenotype. GBS is subclassified into classic and localized forms (for example, pharyngeal–cervical–brachial weakness and bifacial weakness with paraesthesias), and MFS is divided into incomplete (for example, acute ophthalmoparesis, acute ataxic neuropathy) and CNS subtypes (Bickerstaff brainstem encephalitis). Diagnostic criteria based on clinical characteristics are suggested for each condition. We believe this approach to be more inclusive than existing systems, and argue that it could facilitate early clinical diagnosis and initiation of appropriate immunotherapy.

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Change history

  • 07 October 2014

    In Box 1 of the originally published article, Jong Seok Bae should have been included as a member of the GBS Classification Group. Also, in Table 2, the row title 'Bifacial weakness with distal paraesthesias' should have read 'Bifacial weakness with paraesthesias'. These errors have been corrected in the HTML and PDF versions of the article.

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Acknowledgements

The authors are grateful to James Sejvar for his suggestions and critical reading of the manuscript. The authors' work was supported by the Singapore National Medical Research Council (Individual Research Grant 10nov086 and Clinician Science Award 047/2012 to N.Y.) and Yong Loo Lin School of Medicine, Singapore (R-172-000-264-733).

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B.R.W. and N.Y. researched data for the article and contributed equally to writing the article. B.R.W., A.U., N.Y. and all members of the GBS Classification Group made substantial contributions to discussions of the content, and review and/or editing of the manuscript before submission.

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Correspondence to Nobuhiro Yuki.

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Wakerley, B., Uncini, A., Yuki, N. et al. Guillain–Barré and Miller Fisher syndromes—new diagnostic classification. Nat Rev Neurol 10, 537–544 (2014). https://doi.org/10.1038/nrneurol.2014.138

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