new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
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Can Someone tell me how to differentiate between GBS & Botulism without the history of diarrhea n wound history the differentiation on Clinical signs n symptoms
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| mms
Forum Junior
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Posts: 72
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Guillain Barre usually present with an ascending pattern of muscle weakness (botulism with a descending pattern), except for the rare Miller-Fisher GBS variant that is also descending...that's all I found for now but I'm still searching
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| mms
Forum Junior
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Posts: 72
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it seems that GBS often start with with sensory complaint, then rapid loss of tendon reflexes. Rarely beginning with cranial nerve disfunction (Miller-Fisher variant?) and does not alter pupillary reactivity.
So if I understand it right ascending pattern would indicate GBS and in case of descending pattern the presence or absence of pupillary reflexes helps to differenciate if it is GBS Miller -Fisher variant (pupillary reactivity fine) or botulism (pupillary reactivity disfunctional)
Please check it out to be sure that I understood it right
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| silver
Forum Guru
Topics: 21
Posts: 771
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both of them have overlapping symptoms, but it's the minute differences that you have to keep track of.
1. GBS has symmetric ASCENDING limb weakness and botulism has symmetric DESCENDING weakness.
2. GBS has loss of sensations/paresthesias, etc. In Botulism sensations remain intact and patient is responsive....no sensory deficits
3. both have loss of deep tendon reflexes
4. botulism: dilated or unreactive pupils (50% of patients), diplopia, blurred vision. GBS: tonic pupils
5. no cranial nerve involvement in botulism whereas in GBS there is.
**the miller-fisher is a rare variant presenting with a triad: ataxia, areflexia, and ophthalmoplegia.
6.GI symptoms are more prominent in food-borne botulism but not wound botulism. GBS also has GI symptoms.
that covers the basic differences. and of course the causative organisms are also one of the differentiating factors.
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