Patients aged 18 years or more with GBS were identified through the electronic health system and/or electrophysiology database in each center. The inclusion criteria were adopted from the previously validated Brighton criteria, [11, 12] and included (1) acute or subacute flaccid weakness involving lower and/or upper limbs; (2) monophasic disease, reaching nadir of weakness between 12 h and 4 weeks; and at least one of the following: (a) hyporeflexia or areflexia in the weak limbs, (b) cytoalbuminological dissociation defined as the combination of cerebrospinal fluid (CSF) protein level > 0.45 g/L and cell count < 50 cells/µl, and (c) the reported electrophysiological features are compatible with a subtype of GBS. We accepted the subtype classification documented by the treating neurologists/neuromuscular specialists, because the lack of availability of electrophysiological raw data in most centers hindered our ability to confirm subtype classification. We allowed relative preservation of deep tendon reflexes in otherwise typical GBS presentations as has been described in a minority of patients [1214]. We included patients who presented with the classical triads of Miller-Fisher syndrome (MFS): ataxia, ophthalmoplegia, and areflexia. The exclusion criteria were (1) progressive weakness for > 8 weeks, (2) CSF cell count ≥ 50 cells/µl, (3) onset of post-bariatric surgery, and (4) symptoms explained by an alternative diagnosis.

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