QuestionSBA
QuestionChoice
Fasciculations are a sign of an upper motor neurone lesion, and are seen in amyotrophic lateral sclerosis (and to a lesser extent in some other more common conditions). It would not be present in a patient with Guillain-Barre syndrome.
10006914
d
Fasciculations in hands and arms
QuestionChoice
Muscle wasting is not a typical sign of Guillain-Barre syndrome, and may be caused by inactivity, or conditions such as muscular dystrophy.
10006915
e
Lower limb muscle wasting
QuestionChoice
This may be a sign of Lambert-Eaton myasthenic syndrome (LEMS), which is associated with lung cancer. It causes weakness in muscles around the body, with autonomic dysfunction. Weakness typically improves with exercise, and then begins to worsen again. Improvement with exercise would not be exhibited in patients with GBS.
10006912
b
Muscle weakness improving with use
QuestionChoice
Patients with Guillain-Barre syndrome characteristically have reduced or absent deep tendon reflexes. GBS is a common cause of acute peripheral neuropathy, and typically occurs following a recent infection. It causes symmetrical ascending weakness which begins in the legs. Severe cases can result in severe respiratory muscle weakness necessitating ventilatory support.
10006911
a
Reduced knee-jerk reflex
QuestionChoice
Weakness on mastication (chewing) is seen in a majority of patients with myasthenia gravis (MG). However, it is very rarely seen in Guillain-Barre syndrome (GBS). Myasthenia gravis is an important differential diagnosis for GBS. However, MG typically affects the small and proximal muscles of the face and neck initially, while GBS is an ascending weakness beginning in the legs. MG is usually caused by circulating acetylcholine receptor antibodies.
10006913
c
Weakness of mastication
QuestionComment
The explanation for fasciculations is wrong - they are a sign of LMN lesions, not UMN. 
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Gas Relapse
Concept
Chapter
2693
4384
Guillain-Barre Syndrome
Topic
141
Neurology
13929
A 38-year-old male presents to his GP complaining of worsening tingling and numbness in both hands, as well as new severe weakness in his feet and calves. These symptoms started about seven days ago. He reports that he had a bout of non-bloody diarrhoea approximately two weeks ago following a barbeque. Following examination and further investigations, a diagnosis of Guillain-Barre syndrome (GBS) is made.

Which of the following examination findings would most likely be found on examination of this patient?
a