Guillain Bare Syndrome Flashcards
what type of disease is GBS?
-2
autoimmune
polyneuropathy
what structure is damaged in GBS?
peripheral nerves
what happens to muscle?
flaccis paralysis
what happens to muscle tone?
↓tone
what happens to muscle strength?
weakness
patient’s antibodies attack what molecule in which system?
what are these antibodies caleld?
gangliosides
PNS
anti-ganglioside antibody
anti-GM1 antibody stands for what?
how many pt is it present in?
-% wise
anti-ganglioside antibody
25%
is inflammation acute or chronic?
acute
what are the 2 main subtypes of GBS?
Acute inflammatory demyelinating polyneuropathy
Acute motor axonal neuropathy
which subtype involved myelin destruction?
what cell destroys the myelin?
which cell activates the above cell?
Acute inflammatory demyelinating polyneuropathy
macrophages
T cell
which subtype involved a specific antibody attacking axons?
which immunoglobulin is it?
Acute motor axonal neuropathy
IgG
the pathophysiology of GBS has been given what term?
explain this pathophysiology?
molecular mimicry
infection –> some viruses have similar antigens to gangliosides –> antibodies confused and attack gangliosides
where on the neurones are gangliosides located?
axolemma
which bacteria has antigens similar to gangliosides?
campylobacter
which muscles groups become weak first?
legs
are the proximal or distal muscles affected first?
proximal first
is the muscle weakness progressive or not?
progressive
due to extraocular muscle weakness what symptoms can occur?
15%
due to oropharyngeal weakness what symptoms can occur?
speech problems
what happens to reflexes?
Hyporeflexia
what happens to muscle tone?
hypotonia
where can paraesthesia occur?
is the paraesthesia mild or sever?
hands and feet
usually mild
1st line Ix?
-2
result for each?
LP - ↑protein with normal WBC count
Nerve conduction study - slower
what is the result on spirometry?
↓vital capacity
what is the result on LP?
explain this result?
how long would it take for these results to be seen on a CSF?
↑protein
because of inflammation
3 days for protein to elevate in CSF
1st line Mx?
-2
combining the above two Mx gives a synergistic effect. true or false?
Plasma exchange
high dose IV immunoglobulin
false (no synergistic effect)
what is prognosis?
good or bad
good recovery
2-5% of GBS patients die from what complication?
resp failure
Plasma exchange
is oft abbreviated to what term?
how does this procedure work?
PLEX
remove their blood, centrifuge to separate, give back their rbc & wbc. give healthy donated FFP
which blood product contains the antibodies?
FFP
why do you not do IV immunoglobulin in IgA deficient patients ?
SE = anaphylaxis
list all symptoms of GBS?
-8
Progressive muscle weakness Leg/back pain 65% speech problems facial weakness diplopia hypotonia Hyporeflexia Paraesthesia hand & feet (80%)
complication of leg muscle weakness?
DVT
list complications?
Resp muscle weakness
Cranial nerve involvement- diplopia
Autonomic nerves effected
DVT
if autonomic nerves are effected.
what features will you see?
-4
urinary retention, diarrhoea, BP or HR changes
how any GBS pts require ventilation at some point?
%wise
and why?
30%
resp muscle weakness
what is typical history?
rapid acute onset of symptoms, lots of muscle weakness.
what does GBS stand for?
Guillain Barre Syndrome
