DISEASE- Guillian Barre

Question 1

Guillain Barre syndrome- what?

Answer 1

Acute paralytic polyneuropathy that causes demyelination of the peripheral nervous system

Question 2

Guillain Barre syndrome- cause?

Answer 2

Usually demyelinating or occasionally axonal, and has an immune-mediated, often post-infectious, basis

Particularly associated with:
-Campylobacter jejuni
-Cytomegalovirus
-Epstein-Barr virus

Question 3

Guillain Barre syndrome- pathophysiology?

Answer 3

Molecular Mimicry:
-The B cells of the immune system create antibodies against the antigens on the pathogens causing the infections
-These antibodies also match proteins on nerve cells
-They may target proteins on the myelin sheath or nerve axon

Question 4

Guillain Barre syndrome- presentation?

Answer 4

Acute, symmetrical, ascending weakness (starts at feet and moves up the body)

Progressive paraplegia over days up to 4 weeks:
* Sensory loss or neuropathic pain (Can affect sensory nerves)
* Reduced reflexes
* May progress to facial nerve and cause facial weakness
* Autonomic involvement (urinary retention, bowel problems)

Peripheral neuropathy= high stepping gait

Peak symptoms are 10-14 days into onset of illness (exam can be normal during initial phase of illness)

Question 5

Guillain Barre syndrome- investigations?

Answer 5

Can be clinical diagnoses

Nerve conduction studies:
-decreased motor conduction velocity

Lumbar puncture for CSF:
-raised protein
-normal cell count and glucose

Question 6

what should be monitored and why?

Answer 6

bedside spirometry (FVC) monitoring essential due to risk of respiratory failure