[When Guillain-Barré syndrome is not monophasic: Distinguishing recurrent Guillain-Barré syndrome from acuteonset chronic inflammatory demyelinating polyneuropathy and nodopathies].

Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy typically characterized by a monophasic course and rapid progression of weakness. However, in a subset of patients, the clinical evolution may deviate from this expected pattern, creating important diagnostic challenges. Recurrence of symptoms, progression beyond eight weeks, or an atypical treatment response may suggest alternative diagnoses such as acute-onset chronic inflammatory demyelinating polyneuropathy or autoimmune nodopathies. Distinguishing these entities is essential because they differ in pathophysiology, clinical course, prognosis, and therapeutic strategies. Whereas GBS usually responds well to short-course immunotherapy, chronic inflammatory demyelinating polyneuropathy (CIDP), often requires maintenance immunomodulatory treatment, and IgG4 antibody-associated nodopathies may show limited response to intravenous immunoglobulin. In this manuscript, we review the clinical, electrophysiological, and temporal features that help distinguish recurrent GBS, acute-onset CIDP, and autoimmune nodopathies. We also discuss the importance of longitudinal clinical follow-up and serial electrophysiological studies for establishing an accurate diagnosis and guiding appropriate therapeutic management.