GBS long-term deficits typically involve which pattern?

• A. Proximal shoulder girdle weakness predominates
• B. Cognitive impairment
• C. Distal muscles most affected with foot drop and weak hand intrinsics; numbness and proprioceptive deficits
• D. Seizures

Answer: (C)

In Guillain-Barré syndrome, long-term deficits tend to follow a length-dependent, distal pattern. The nerves that are longest—the ones supplying the feet and hands—are most affected, so the residual weakness and sensory changes show up distally. This means patients often have foot drop and weakness of the hand intrinsics, along with numbness and impaired proprioception in the distal limbs. Cognition and seizures involve the central nervous system and aren’t typical of GBS’s peripheral neuropathy, so they don’t fit the usual post-GBS deficit profile. Although weakness can be more prominent proximally during the acute phase, the persistent, long-term deficits are most characteristic distally, aligning with the stocking-glove distribution of sensory and motor loss.