Table 1

Overview of Brighton Collaboration criteria for diagnosis of Guillain-Barré syndrome (GBS) and Miller Fisher syndrome and proposed criteria for diagnosis of facial diplegia with paraesthesias variant of GBS, adapted from the Brighton Collaboration criteria19 24

GBS variantLevel of diagnostic certainty
Level 1Level 2Level 3Level 4
Sensorimotor and motor variantsBilateral and flaccid weakness of the limbs
AND
Decreased or absent deep tendon reflexes in weak limbs
AND
Monophasic illness with weakness nadir 12 hours to 28 days from the onset and subsequent clinical plateau
AND
Absence of an alternative diagnosis		Suspected GBS with no other diagnosis apparent, which does not meet level 3 criteria
CSF white cell count <50 cells/µL
OR
If CSF unavailable, electrophysiological studies consistent with GBS		 -
CSF white cell count <50 cells/µL with raised CSF protein
AND
Electrophysiological studies consistent with GBS		 -
 Level 1Level 2Level 3Level 4
Miller Fisher SyndromeBilateral ophthalmoparesis
AND
Bilateral decreased or absent tendon reflexes
AND
Ataxia
AND
Monophasic illness with weakness nadir 12 hours to 28 days from the onset and subsequent clinical plateau
AND
Absence of limb weakness
AND
Absence of alterations in consciousness or corticospinal tract signs
AND
Absence of an alternative diagnosis		Suspected Miller Fisher syndrome with no other diagnosis apparent, which does not meet level 3 criteria
CSF white cell count <50 cells/µL
OR
Nerve conduction studies normal OR show involvement of sensory nerves only		 -
CSF white cell count <50 cells/µL with raised CSF protein
AND
Nerve conduction studies normal OR show involvement of sensory nerves only		 -
 Level 1Level 2Level 3Level 4
Facial diplegia with paraesthesiasBilateral lower motor neuron facial weakness
AND
Bilateral paraesthesia of the lower and/or upper limbs
AND
Absence of limb weakness
AND
Monophasic illness with weakness nadir 12 hours to 28 days from the onset and subsequent clinical plateau
AND
Absence of an alternative diagnosis		Suspected facial diplegia with paraesthesias variant with no other diagnosis apparent, which does not meet level 3 criteria
CSF white cell count <50 cells/µL
OR
If CSF unavailable, electrophysiological studies consistent with GBS		 -
CSF white cell count <50 cells/µL with raised CSF protein
AND
Electrophysiological studies consistent with GBS		 -

  • CSF, cerebrospinal fluid.