Speaker Series: GBS and CIDP 101

Dr. Kenneth Gorson is a Professor of Neurology at Tufts University School of Medicine and a leading clinician at St. Elizabeth’s Medical Center, where he specializes in neuromuscular disorders. With decades of experience in the diagnosis and management of conditions such as Guillain-Barré syndrome and CIDP, Dr. Gorson is widely recognized for his contributions to patient care, clinical research, and medical education. He previously served as Chair of the Global Medical Advisory Board for the GBS|CIDP International Foundation, where he helped guide clinical and scientific priorities to improve outcomes for patients worldwide.

GBS is a rare autoimmune disease (1–2 per 100,000) typically triggered by an infection. The immune system mistakenly attacks the myelin (nerve lining), disrupting nerve signals and causing rapidly progressive weakness, numbness, and sometimes paralysis.

• Rapidly progressing weakness (days to weeks)
• Difficulty walking, climbing stairs, or using hands
• Numbness, tingling, and nerve pain
• In severe cases, paralysis and breathing difficulty (up to 1/3 require ventilator support)

It is a matter of severity. Weakness allows some movement, while paralysis means complete inability to move muscles.

• Primarily a clinical diagnosis (history + physical exam)
• Supported by:
  • EMG/nerve conduction studies
  • Lumbar puncture (elevated protein, no inflammation)

Typically 1–3 days in ideal settings, but delays are common due to the rarity and evolving symptoms.

• IVIG (intravenous immunoglobulin) – 5-day course
• Plasma exchange (plasmapheresis)
• Both are equally effective and used once (not repeated routinely)

Yes. Most patients recover over time, even without treatment, but treatment reduces complications and speeds recovery.

• ~80% regain independent function
• Many have residual symptoms (fatigue, pain, weakness)
• ~20% may have long-term disability

• Symptom-based treatment (e.g., neuropathic pain medications)
• Physical and occupational therapy
• Not treated with IVIG or plasma exchange

Rare (<5%). GBS is generally a one-time illness.

• New therapies targeting the immune system (e.g., complement inhibitors)
• Promising trial results showing faster recovery

CIDP is a chronic autoimmune nerve disorder with similar symptoms to GBS but progresses slowly over weeks to months.

• GBS: acute, rapid onset
• CIDP: chronic, slow progression
• CIDP requires long-term management

No clear triggers are typically identified.

• Clinical evaluation
• EMG/nerve conduction studies
• Lumbar puncture (elevated protein)

Symptoms progress slowly and can mimic many other conditions; diagnosis may take up to a year.

• IVIG (ongoing, every 3–4 weeks)
• Corticosteroids (e.g., prednisone)
• Plasma exchange
• Subcutaneous immunoglobulin
• Newer therapies (e.g., efgartigimod)

Not always. The goal is to:

• Stabilize the patient
• Then attempt to wean off treatment if possible

Progressive nerve damage can lead to permanent disability.

• Reevaluate the diagnosis
• Ensure proper dosing
• Switch therapies if needed
• Consider alternative diagnoses

Rarely. Consider CIDP if:

• Symptoms persist beyond 8 weeks
• There are multiple relapses
• New symptoms develop after initial recovery

Essential for maintaining function, mobility, and quality of life.

• 7+ active clinical trials
• Focus on monoclonal antibodies and complement inhibition
• New targeted immune therapies under investigation