Term
| What is the definition of Guillain-Barre Syndrome? |
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Definition
It is an acute form of polyneuropathy due to an autoimmune process affecting the peripheral nervous system.
Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom. It can cause life-threatening complications, particularly if the diaphram is affected. The disease is usually triggered by an acute infection. |
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Classifications of Guillain-Barre |
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Definition
•Ascending GBS: Weakness and paresthesia/dysasthesia begin in legs and ascend to the trunk, arms and cranial nerves. Respiratory distress in 50% of cases.
•Descending GBS: Weakness and paresthesia/dysasthesia begins in areas innervated by cranial nerves and descends to the trunk and extremities. Respiratory involvement present in most patients.
-Miller-Fisher variant GBS: Ataxia, opthalmoplegia, areflexia, no sensory symptoms and respiratory involvement is rare. |
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Term
What is the Pathophysiology of Guillain-Barre? |
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Definition
•Acute DemyelinatingPolyneuropathy
•Acquired, demyelinating the peripheral nerves sparing the axons.
•Local infiltration by T-cell lymphocytes and macrophages which progressive attack and destroy the myelin thus slowing the conduction and resulting in muscle weakness.
•Affecting the Schwann cells ** |
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Term
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Definition
•Recent trauma to spine or peripheral nerves?
•Family history of CNS disorders?
•Where/when did the weakness begin?
•Where/when did the sensory changes begin?
•Neuralgia of the lower extremities, flank or bank?
•Recent illness, surgery or vaccination? |
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Term
What is the presentation of a patient with GBS? |
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Definition
•May be anxious or in respiratory distress.
•Diaphoresis
•Hemodynamic instability, Dysrhythmias
•Tachypnea
•Bladder distention due to urinary retention
•Abdominal distention, diminished bowel sounds
•Pupillary abnormality, cranial nerve dysfunction, generalized motor weakness or paralysis, sensory abnormalities, areflexia or hyperreflexia. |
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Term
What are the Differential Diagnosis for GBS? |
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Definition
•Poliomyelitis
•Myasthenia Gravis
•Botulism
•Tick paralysis |
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What are the Diagnostic Tests for GBS? |
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Definition
•Lumbar puncture with CSF studies: normal opening pressure, few or no cells and increased protein.
•Nerve Conduction Velocities: demyelination evidenced by reduction of amplitude of muscle action potential with distal nerve stimulation. |
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Term
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Definition
•Consult Neurology
•Hospitalize: Need respiratory support, possible mechanical ventilation
•Cardiovascular support: ECG, PA line, Arterial line, Temporary pacer if has complete heart block, symptomatic bradycardia, hydration and volume expansion.
-Early TPN
-Plasmphoresis my reduce duration and severity of symptoms
•Pain medication, NSAIDS, antidepressants
•DVT prophylaxis
•PT, OT, speech- early rehabilitation
•Psychosocial support and counseling
•Discharge planning: 80% need inpatient rehabilitation
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