Which symptom is least likely to be associated with Guillain-Barre syndrome?

Guillain-Barre syndrome (GBS) is characterized by a progressive ascending paralysis, typically starting in the lower extremities and advancing upwards. A hallmark of this condition is the presence of flaccid paralysis, which often occurs without significant muscle atrophy in the early stages. Additionally, patients may experience sensory symptoms such as paresthesias and pain.

The correct choice reflects the characteristic feature of unchanging deep tendon reflexes. In GBS, deep tendon reflexes are typically diminished or lost, especially as the condition progresses; therefore, the presence of unchanging reflexes is inconsistent with the syndrome. This contrasts with the other symptoms, which are more commonly associated with GBS.

Loss of bowel and bladder control can occur as the syndrome affects autonomic function. Flaccid paralysis without atrophy aligns with the initial presentation of GBS. Paresthesias and pain are common reports from patients experiencing GBS as a result of nerve inflammation and damage. Thus, the symptom that is least likely to be associated with Guillain-Barre syndrome is the persistence of unchanging deep tendon reflexes.