49. Guillain-Barre syndrome

Question 1

What is Guillain-Barre syndrome?

Answer 1

Manifested as acute inflammatory polyradiculoneuropathy, a demyelinating, autoimmune disease inv. peripheral nerves. Occur mostly in young adults.

Question 2

Cause

Answer 2

Viral infection, immunization, allergic reactions

Question 3

Signs and symptoms

Answer 3

Weak. and tingeling in the lower extremities as first symptoms –> paralyzing upwards, over hrs-days.
Inv. the arms, truncal mus., CNs, and mus. of resp.

Prickling, sens. in fingers, toes, ankles, wrists
Facial droop, diplopias, dysarthria, dysphagia, ophthalmoplegia, pupillary disturbances
Pain (ach or throb) in shoulder girdle, back, buttocks, and thighs

Tachyc., bradyc., parox. hyperT, orthostatic hypoT
Facial flushing
Anhidrosis and/or diaphoresis, urinary retention
Dyspnea (exertion), shortness of breath
Slurred speech

Question 4

Diagnosis

Answer 4

Albumino-cytologic dissociation of CSF
Increased protein concentration w/little increase in cell count

Electrolyte levels, liver function tests, CPK level, ESR, pulmonary function, CSF studies, needle EMG and nerve conduction studies

Question 5

Treatment

Answer 5

May cause death, but most pat. recover.
Immunomodulatory treatment has been used to hasten recovery. IV immunoglobulin (IVIG) and plasma exchange have proved equally effective.