Association between tuberculosis and Guillain–Barré syndrome: a systematic review

• First systematic review of TB-associated GBS, 29 cases worldwide. • 61 % developed GBS within 2 weeks of TB, suggesting immune-mediated trigger. • Mortality 17.2 %, higher than classical GBS; highlights need for early recognition. Tuberculosis (TB) is highly prevalent in low- and middle-income countries and may present with diverse neurological complications. Its possible association with Guillain–Barré Syndrome (GBS) is rarely reported, but recognition is important because it poses diagnostic challenges and has impotant implications for management in endemic settings. We systematically reviewed literature from PubMed, Scopus, Google Scholar, Web of Science, and Semantic Scholar (to December 2024) following PRISMA guidelines. We identified 29 cases of TB-associated GBS, with the highest number reported from India (44.8 %). Pulmonary TB was the predominant form (62.1 %), with acute inflammatory demyelinating polyneuropathy (AIDP, 20.7 %) most common. A majority (60.7 %) developed GBS within two weeks of TB symptom onset. Clinical outcomes included complete recovery in 58.6 % and mortality in 17.2 %. Current evidence is limited to case reports and small series, suggesting TB may potentially act as a trigger for GBS, but causality remains unproven. Further controlled studies are needed to clarify mechanisms and outcomes.