Current RMA Instruments
| Reasonable Hypothesis SOP | 23 of 2018 as amended |
| Balance of Probabilities SOP | 24 of 2018 as amended |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: G61.0
Brief description
Guillain-Barre syndrome is an acute autoimmune disorder of peripheral nerves. It usually causes rapidly progressive muscle weakness leading to paralysis, as well as sensory and autonomic nerve dysfunction. There are several variant forms. Hospitalisation and ventilation are often required. Full recovery over months is usual but some weakness may persist.
Confirming the diagnosis
This is a complex diagnosis usually requiring MRI [Magnetic resonance imaging] scans of the brain and spinal cord, spinal puncture and electrophysiological studies of the nerves and muscles.
The relevant medical specialist is a neurologist.
Additional diagnoses covered by SOP
- Acute inflammatory demyelinating polyneuropathy
- Acute motor axonal neuropathy
- Acute motor sensory axonal neuropathy
- Miller Fisher syndrome
Conditions excluded from SOP
- Chronic inflammatory demyelinating polyneuropathy with nerve root involvement#
- Infective polyneuropathy
- Peripheral neuropathy*
* another SOP applies
# non-SOP condition
Clinical onset
This is a condition with an acute onset. Clinical onset will typically be a few days to a week before the first presentation for medical attention. The main symptom is weakness, which can vary from mild difficulty with walking to nearly complete paralysis of all extremity, facial, respiratory, and bulbar muscles.
Clinical worsening
The only worsening factor is for inability to obtain appropriate clinical management. Intensive care treatment may be required. 30 percent of patients develop neuromuscular respiratory failure requiring mechanical ventilation. 3 to 7% of patients die within one year despite appropriate treatment. The acute phase of the illness lasts a few weeks. Full recovery within one year occurs in about 60 percent of patients.