Ruts et al identified factors distinguishing Guillain-Barre Syndrome (GBS) with treatment-related fluctuations (TRF) from chronic inflammatory demyelinating polyneuropathy (CIDP) with acute onset. The authors are from the Dutch GBS Study Group.



(1) time to first deterioration

(2) number of clinical deteriorations

(3) ability to walk independently

(4) cranial nerve dysfunction

(5) electrophysiologic features compatible with CIDP



GBS with TRF

acute onset CIDP

first deterioration

within 8 weeks

after 8 weeks

number of deteriorations

1 or 2

3 or more

walking independently

often unable

often able

cranial nerve dysfunction




not consistent with CIDP

consistent with CIDP


A patient with features of acute onset CIDP should be considered for CIDP maintenance therapy.


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