Table 1.

The Brighton Criteria for diagnosis of GBS and Fisher syndrome.

Clinical case definitions: Guillain–Barré syndrome (GBS)
Level 1 of diagnostic certainty
Bilateral AND flaccid weakness of the limbs AND
Decreased or absent deep tendon reflexes in weak limbs AND
Monophasic illness pattern10 AND interval between onset and nadir of weakness between 12 h and 28 days AND subsequent clinical plateau AND
Electrophysiologic findings consistent with GBS AND
Cytoalbuminologic dissociation (i.e., elevation of CSF protein level above laboratory normal value AND CSF total white cell count <50 cells/μl) AND
Absence of an identified alternative diagnosis for weakness
Level 2 of diagnostic certainty
Bilateral AND flaccid weakness of the limbs AND
Decreased or absent deep tendon reflexes in weak limbs AND
Monophasic illness pattern AND interval between onset and nadir of weakness between 12 h and 28 days AND subsequent clinical plateau AND
CSF total white cell count <50 cells/μl (with or without CSF protein elevation above laboratory normal value) OR
IF CSF not collected or results not available, electrophysiologic studies consistent with GBS AND
Absence of identified alternative diagnosis for weakness
Level 3 of diagnostic certainty
Bilateral AND flaccid weakness of the limbs AND
Decreased or absent deep tendon reflexes in weak limbs AND
Monophasic illness pattern AND interval between onset and nadir of weakness between 12 h and 28 days AND
subsequent clinical plateau AND
Absence of identified alternative diagnosis for weakness
Clinical case definitions: Fisher syndrome (FS)
Level 1 of diagnostic certainty
Bilateral ophthalmoparesis AND bilateral reduced or absent tendon reflexes, AND ataxia AND
Absence of limb weakness AND
Monophasic illness pattern AND interval between onset and nadir of weakness between 12 h and 28 days AND subsequent clinical plateau AND
Cytoalbuminologic dissociation (i.e., elevation of cerebrospinal protein above the laboratory normal AND total CSF white cell count <50 cells/μl]) AND
Nerve conduction studies are normal, OR indicate involvement of sensory nerves onlyAND
No alterations in consciousness or corticospinal tract signs AND
Absence of identified alternative diagnosis.
Level 2 of diagnostic certainty
Bilateral ophthalmoparesis AND bilateral reduced or absent tendon reflexes AND ataxia AND
Absence of limb weakness AND
Monophasic illness pattern AND interval between onset and nadir of weakness between 12 h and 28 days AND subsequent clinical plateau AND
Cerebrospinal fluid (CSF) with a total white cell count <50 cells/μl])(with or without CSF protein elevation above laboratory normal value) OR
Nerve conduction studies are normal, OR indicate involvement of sensory nerves only AND
No alterations in consciousness or corticospinal tract signs AND
Absence of identified alternative diagnosis
Level 3 of diagnostic certainty
Bilateral ophthalmoparesis AND bilateral reduced or absent tendon reflexes AND ataxia AND
Absence of limb weakness AND
Monophasic illness pattern AND interval between onset and nadir of weakness between 12 h and 28 days AND subsequent clinical plateau AND
No alterations in consciousness or corticospinal tract signs AND
Absence of identified alternative diagnosis