GBS

Question 1

What is GBS also known as

Answer 1

Acute and chronic inflammatory demyelination polyradiculopathy

Question 2

Other associated diseases of GBS

Answer 2

Miller fisher syndrome

CIDP

Question 3

Miller fisher syndrome is primarily (4)

Answer 3

Cranial nerve Sx
Ataxia
Areflexia
NOT extremity weakness

Question 4

Prognosis for Miller fisher

Answer 4

Recovery in 2-4 weeks

Resolved in 6 months

Question 5

CIDP

Answer 5

Progressive or RR numbness and weakness

Question 6

Define GBS

Answer 6

Rapidly evolving, symmetrical ascending weakness

Question 7

GBS is sometimes reported after

Answer 7

Flu shots

Question 8

Disease progression of GBS

Answer 8

Spinal roots and peripheral nerves are attacked by macrophages and T lumps which affect the myelin sheath or the axon itself

Question 9

What’s the result of the attack?

Answer 9

Reduction in nerve velocity

Question 10

Why do cells recover with GBS?

Answer 10

Schwann cells can re-innervate within the CNS and axons can grow

Question 11

Medical management of GBS

Answer 11

20-30% need assisted vent
50% cranial nerve involvement
50% altered ANS

Question 12

Who gets more affected with GBS and what about incidence?

Answer 12

Males 2x as more and incidence of GBS increases by 20% every 10 years

Question 13

GBS affects what leading to what

Answer 13

Affects nerve roots and peripheral nerves leading to neuropathy and flaccid paralysis

Question 14

Prognosis of GBS

Answer 14

Good but less if theres axonal damage

Question 15

Max paralysis when?

Answer 15

1st week and weakness can increase for first 1-2 months

Question 16

Treatments immune

Answer 16

Plasma exchange and IVIg

Question 17

What’s plasma exchange

Answer 17

Removal and plasma and re-transfusion of formed elements into blood

Question 18

What’s IVIg

Answer 18

Blood speared into plasma and returning blood cells with plasma substitute

Question 19

Pharm mgmt

Answer 19

NO corticosteroids

Question 20

GBS Disease progress

Answer 20

Recovery starts 2-4 wks after progression stops

Question 21

Ambulation? But?

Answer 21

80% within 6 months but 15% still have deficits

Question 22

Residual weakness most common

Answer 22

In ant tib
Foot and hand intrinsics
Quads and glutes

Question 23

Sensation with GBS

Answer 23

Can continue for years

Question 24

What determines poorer outcomes?

Answer 24

If they need mechanical vent

Question 25

PT interventions (5)

Answer 25

Respiratory care
Education
Pain mgmt
Contracture and sore prevention-positioning
PROM

Question 26

What to watch for with PROM

Answer 26

Muscles are flaccid so dont overstretch beyond normal limits

Question 27

Strength usually returns

Answer 27

OPPOSITE pattern of how it was lost

Question 28

Describe pattern of loss

Answer 28

Deficits usually happen: LE, UE, face. Cranial nerves

Strength returns: face, UE, LE

Question 29

Will exercise influence the regeneration rate

Answer 29

NO

Question 30

Once stable

Answer 30

Do functional activities with short periods

Question 31

Only increase exercise when

Answer 31

No declines and shows improvement

Question 32

If worsens

Answer 32

Return to bedrest

Question 33

Fatiguing exercise usually limited

Answer 33

For 1 year post op

Question 34

Active exercise with GBS

Answer 34

Start in rarity eliminated, can use slider in SL or do PNF

Question 35

Splinting to? and when?

Answer 35

To protect joints in weakening or recovery phase