Guillain-Barré syndrome typically presents with which clinical feature?

• A. Chronic progressive weakness
• B. Localized sensory loss
• C. Facial palsy only
• D. Acute onset ascending weakness with areflexia; may require IVIG or plasmapheresis

Answer: (D)

Guillain-Barré syndrome is an acute inflammatory neuropathy defined by rapid, progressive weakness with loss of reflexes. The key feature is an acute onset that starts in the legs and ascends upward, often with areflexia. This pattern, along with potential cranial nerve involvement and autonomic symptoms, points to a peripheral nerve attack rather than a localized problem. Treatment aims to modulate the immune response and typically includes intravenous immunoglobulin or plasmapheris, which can improve outcomes. This description fits best because Guillain-Barré usually presents as acute ascending weakness with absent reflexes, rather than a chronic course, localized sensory loss, or weakness confined to the facial muscles.