Which CSF finding is typical of Guillain-Barré syndrome?

Which CSF finding is typical of Guillain-Barré syndrome?

• A. Elevated protein with high cell count
• B. Elevated protein with normal cell count
• C. Low protein with high glucose
• D. Normal protein with high WBC count

Answer: (B)

The CSF finding in Guillain-Barré syndrome is albuminocytologic dissociation: elevated protein with a normal cell count. This happens because the immune-mediated attack on peripheral nerves increases the permeability of the blood-nerve barrier, allowing protein to leak into the CSF, while there isn’t significant meningeal inflammation to raise the white blood cell count. The protein elevation often appears after about a week or two of symptoms, and the cell count remains normal or only mildly elevated. Other patterns don’t fit Guillain-Barré. Elevated protein with a high cell count points toward meningitis or encephalitis, where meninges are inflamed. Low protein with high glucose isn’t typical of this syndrome, and normal protein with a high white blood cell count suggests inflammatory or infectious processes involving the meninges rather than the peripheral nerves.

The CSF finding in Guillain-Barré syndrome is albuminocytologic dissociation: elevated protein with a normal cell count. This happens because the immune-mediated attack on peripheral nerves increases the permeability of the blood-nerve barrier, allowing protein to leak into the CSF, while there isn’t significant meningeal inflammation to raise the white blood cell count. The protein elevation often appears after about a week or two of symptoms, and the cell count remains normal or only mildly elevated.

Other patterns don’t fit Guillain-Barré. Elevated protein with a high cell count points toward meningitis or encephalitis, where meninges are inflamed. Low protein with high glucose isn’t typical of this syndrome, and normal protein with a high white blood cell count suggests inflammatory or infectious processes involving the meninges rather than the peripheral nerves.