Practical Management of Guillain-Barré Syndrome and Myasthenic Crisis

Guillain-Barré syndrome and myasthenia gravis are the two most common causes of primary neuromuscular respiratory failure. Although these two conditions have similarities, such as their typically self-limited course and response to immunotherapy, they also have major differences. Guillain-Barré can have an acute presentation complicated by autonomic dysfunction. In these patients early intubation is necessary. Myasthenic patients initially present with fluctuating fatigue and may be successfully treated with noninvasive ventilation if this is initiated early in the course of the neuromuscular decline. This chapter provides practical information to guide the management of patients with Guillain-Barré syndrome and myasthenic crisis in the intensive care unit.