CSF findings in Guillain-Barré syndrome typically show which pattern?

• A. High WBC count with elevated protein and low glucose
• B. Low protein with low glucose
• C. Normal WBC with normal protein and glucose
• D. Normal WBCs with highly elevated protein and normal glucose

Answer: (D)

Guillain-Barré syndrome classically shows albuminocytologic dissociation in the cerebrospinal fluid: a markedly elevated protein concentration with a normal white blood cell count and normal glucose. The high protein results from leakage of serum proteins due to disruption of the blood-nerve barrier as demyelination occurs in the peripheral nerves. There isn’t meningeal inflammation, so the CSF WBC count stays normal, and glucose remains normal because there’s no CNS infection consuming glucose or altering its transport. This combination—high protein with normal WBC and normal glucose—is characteristic. Other patterns, like high WBC with low glucose, point to bacterial meningitis, while viral meningitis can have elevated protein with normal glucose and a mild WBC rise, not the same pronounced protein elevation seen in Guillain-Barré.