GBS Flashcards
GBS
Distinguishing Feature
🧠⚡Guillian LL is silent⚡
NEUROLOGICAL EMERGENCY
⭐ ACUTE ONSET (Less than 4 weeks)
⭐ ASCENDING PARALYSIS
⭐ B/L
⭐ DEMYELINATING CONDITION
⭐ POLYRADICULO-NEUROPATHY
Gullian Barre Syndrome
🧠⚡2 Gu-Baare : Left together ➡️ ascend upwards⚡
✨ Ascending symmetrical paralysis
✨ Axonal degeneration and Demyelination
✨ Respirator Failure
🧑🏻⚕️ Clinical Features of GBS
🧠⚡ABCD ⚡
✨ ABCD: AlBumino-Cytological Dissociation
✨AFP
✨ Bladder incontinence
✨ Cranial Nerve Palsies
✨ DTR lost
LAUNDRY’S PARALYSIS seen in
GBS
Antibodies in Different types of GBS
🧠⚡ M ke sath M nhi⚡
🧠⚡ IIM⚡
MILLER FISHER SYNDROME
🧠⚡IMAGINE A fish TAKEN OUT of water⚡
Average Age Of onset of GBS
40 yrs
AIDP: Pathology
Demyelinating
⭐ 1st ATTACK on Schwann Cells
AXONAL Varients of GBS
Pathology
⭐ AMAN
⭐ AMSAN
Pathology: 1st ATTACKS on NODES OF RANVIER
⭐ Miller Fisher Syndrome
RUBBERY LEGS
➕
TINGLING and DYSESTHESIA of LOWER LIMB
➕
ANS MANIFESTATIONS Prominent
➕
Rapidly Progressive B/L areflexic ASCENDING FLACCID PARALYSIS
➕
Mild TRANSIENT BLADDER DYSFUNCTION
GBS
Fibers affected 1st in GBS
Large FIBER NEUROPATHY
Both Distal ➕ Proximal
ANS Manifestations in GBS
⭐ BP fluctuations
⭐ Postural Hypotension
⭐ Arrhythmia
⭐ Deep aching pain in affected muscle
Trigger infection of GBS
🧠⚡MECH ⚡
✨ Campylobacter jejuni
✨ CMV
✨ EBV
✨ Mycoplasma
✨ Hepatitis A, B
✨ HIV
✨ Post-immunization
Mechanism of CAMPYLOBACTER JEJUNI in GBS
Molecular mimicry with MYELIN
⚡⚡ MOST COMMON CRANIAL NERVE INVOLVED in GBS
7th CN Palsy B/L LMN palsy
⬇️
3rd CN Palsy B/L LMN palsy
Recovery in GBS
Complete
⭐ By 2-4 weeks
Most SENSITIVE Test in Evaluating GBS
Nerve Conduction Studies
Albumino-Cytological dissociation is seen after
⭐ GBS
1 week of Disease
💊💉 MANAGEMENT of GBS
⭐ IVIG 0.4gm/kg x 5 days
(OR)
⭐ PLEX 5 cycles
Mortality increases in GBS if
Cranial nerve involvement
Corticosteroids in GBS
Should NOT BE USED
Diseases requiring Therapeutic Plasmaphersis
🧠⚡CAMP TAR ⚡
- CIDP
- AIDP
- Myasthenia Gravis
- Posts transfusion purpura
- TTP
- Anti-GBM disease
- Refsum’s disease
Descending Paralysis seen in
🧠⚡ BaD P²T⚡
- Botulism (symmetrical)
- Diphtheria
- Polio
- Porphyria
- Tetanus
Ascending Paralysis is seen in
GBS (Symmetrical)
CIDP
Chronic Inflammatory Demyelination Polyradiculo-neuropathy
Cause
💡onset > 2 months
⭐ PRIMARY
⭐ SECONDARY
✨ HIV
✨ HODGKIN’S DISEASE
✨ PLASMA CELL DISORDER:
-MULTIPLE MYELOMA
-POEMS Syndrome
Varients of CIDP
➕
Muscle atrophy like ALS
➕
anti-GM1 Demyelinating condition
➕
Affects ARMS > > > LEGS
MMN-CB: Multi-focal Motor NEUROPATHY with CONDUCTION BLOCK
POEMS SYNDROME
✨ Polyradiculo-neuropathy: CIDP
✨ Organomegaly
✨ Endocrinopathy
✨ Multiple myeloma (Monoclonal Gammopathy)
-Osteosclerotic Lesions
-refractory to therapy
✨ Skin changes
Elevated VEGF
➕
Associated with CASTLEMAN’S DISEASE
POEMS Syndrome
AIDP vs CIDP
Pure Motor NEUROPATHY
🧠⚡ LDM⚡
⭐ Lead
⭐ Dapsone
⭐ Multi-focal Motor NEUROPATHY with CONDUCTION block
Nerve Biopsy is indicated in CIDP
⭐ Diagnosis is not clear
⭐ Other causes of Polyneuropathy cannot be ruled out
⭐ EMG shows AXONAL involvement
Biopsy usually is NOT INDICATED in
Completely degenerated nerves usually convey limited information
