What is the hallmark progression in Guillain-Barré syndrome?

• A. Descending weakness
• B. Symmetric finger numbness only
• C. Ascending weakness
• D. Muscle hypertrophy

Answer: (C)

Guillain-Barré syndrome most notably presents with an ascending motor weakness pattern. Weakness starts in the distal legs and progresses upward to involve the thighs, hips, arms, and sometimes the muscles used for breathing. This upward progression, often with reflex loss, is the hallmark of the condition because it reflects the length-dependent demyelination of peripheral nerves that characterizes GBS.

Sensory symptoms can occur but are usually less prominent than the motor weakness, and the key feature is the progressive ascension of weakness rather than isolated numbness. Muscle hypertrophy is not part of the typical acute neuropathy picture in GBS.

So the best description of the progression is ascending weakness.