Guillain Barre

Question 1

Define Guillain-Barre…
Acute or progressive?
autoimmune?
poly_________?
Progressive or stable?
fairly symmetric/asymmetric muscle weakness?
accompanied by absent/depressed or enhanced/over-excitable deep tendon reflexes?

Answer 1

Acute
and autoimmune
polyneuritis. - multiple peripheral nerves are inflamed or damaged at the same time
Progressive
and fairly symmetric muscle weakness
accompanied by absent or depressed deep tendon reflexes

Question 2

weakness ranges from ____to ______

Answer 2

Difficulty walking to nearly total paralysis

Question 3

What are the most common symptoms? (1)

Answer 3

Weakness in the hands and feet

Question 4

What are the symptoms of Guillain Barre?

Answer 4

Weakness in the hands and feet
Pain in back and extremities
Dysautonomia (messes with the autonomic nervous system): tachycardia, labile BP, orthostatic hypoTN, ileus, urinary retention

Question 5

What proceeds the onset of Guillain Barre syndrome? (4)

Answer 5

Viral infection or immunization, trauma or surgery

Question 6

What week does a patient with GBS reach nadir?

Answer 6

4 weeks

Question 7

How is GBS diagnosed?
3 tests

Answer 7

Hx and physical
CSF will show an increase in protein and normal WBC count one week after infection
Nerve conduction studies and EMG –> dx and prognosis

Question 8

What should you watch for when doing a physical assessment of GBS?

Answer 8

Deterioration happens quickly!
Need for mechanical ventilation
Gag and corneal reflex presence
VS –> autonomic effects!

Question 9

What is the plan of care for GBS?

Answer 9

Physical assessment 
Nutritional interventions
Pain-management
Monitor for urinary retention
Patient and family support and teaching

Question 10

Removal of antibodies, complement, and soluble biological response modifiers
4-6 treatments over 8-10 days

Answer 10

plasmapheresis

Question 11

Besides plasmapheresis, what other intervention can be done to treat the disease?

Answer 11

IV immune globulin

5 days

Question 12

True or False: combining plasmapheresis and IV immune globulin speeds up recovery?

Answer 12

False, providing both does not seem to benefit the patient

Question 13

What week since onset should therapy be administered?

Answer 13

Within 4 weeks of onset

Question 14

What is the prognosis for GBS?

Answer 14

High survival rate, most completely recover

However, some may suffer residual weakness