AIDP Flashcards
What is AIDP?
-acute inflammatory demyelinating polyneuropathy
-Guillian Barre Syndrome
-flaccid paralysis that is initially ascending and progressive
-demyelination of peripheral nerves at the node of ranvier
Who gets AIDP more often men or women?
men
What is the etiology of AIDP?
-common post c-jejuni bacterial infection
-common after influenza, epstein-barr virus, and cytomegalovirus viral infections
-also common after surgery and vaccinations
-90% of patients who got AIDP had a viral or bacterial infection 30 days preceding
What is the pathophysiology of AIDP?
-attacks peripheral nerves
-can attack sensory and motor aspects
-minimal sensory involvement
-anti-inflammatory process involving T-cells and macrophages resulting in demyelination
-can have damage all the way to axons
What are the symptoms of AIDP?
-bilateral ascending weakness
-rapid and progressive initially
-absence of DTR’s
What are the subtypes of AIDP?
-AMAN
-ASAN
-AMSAN
-CIDP
What is AMAN?
-acute motor axonal neuropathy
-more sever
-more likely to have respiratory involvement and vent dependence
-significant residual symptoms
What is ASAN?
-acute sensory ascending neuropathy
-sensory changes more prominent than weakness
What is AMSAN?
-acute motor and sensory axonal neuropathy
-autonomic dysfunction is worse
-postural hypotension
-impaired sweating
-bowel and bladder changes
What are the 3 phases of AIDP?
-progressive
-plateau or stable phase
-recovery phase
What is the progressive phase of AIDP?
-ascending demyelination that progresses anywhere from 2-6 weeks
-4 weeks is average for peak impairment
-can ascend to the cranial nerves and result in facial weakness
-can involve respiratory muscles
-about 30% require mechanical ventilation
-50% ends at 2 weeks
-90% ends at 4 weeks
-can attack autonomics
-watch for arrythmias, tachycardia, BP changes, ileus
-usually kept in acute care
What is the plateau or stable phase of AIDP?
-around 4 weeks when progression stops but remyelination has not fully occurred yet
-usually lasts 2-4 weeks
What is the recovery phase of AIDP?
-nerves start remyelinating and repairing
-process takes months to years depending on level of damage
-recovery happens proximal to distal
What are the clinical features of AIDP?
-bilateral and flaccid weakness of limbs
-decreased or absent DTRs
-absences of alternative diagnosis
How is AIDP diagnosed?
-CSF analysis
-nerve conduction velocity studies
