Clinical features

• paraesthesia or pain in the limbs

• weakness in the limbs (usually symmetrical)

• both proximal and distal muscles affected

• facial and bulbar paralysis

• weakness of extraocular muscles (rarely)

• reflexes depressed or absent

• variable sensory loss but rare

Within 3-4 weeks the motor neuropathy, which is the main feature, progresses to a maximum disability, possibly with complete quadriparesis and respiratory paralysis. 14

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