Guillain Barre Flashcards

0
Q

Définition PRNA

A

Demyelinisation segmentaire multifocale AI transitoire

Médiation humorale

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1
Q

Épidémiologie PRNA

A

50% post infection respi ou dig (CMV, EBV, campylobacter jéjuni)

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2
Q

Évolution PRNA

A

3 phases : extension(svt qqs j mais jusqu’à 4 sem possible), plateau, récupération (15% gardent séquelles)

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3
Q

Clinique extension PRNA

A

Atteinte bilatérale et svt symétrique
Paresthésies distales
Parésie proximale avec abolition ROT, risque atteinte nerfs crâniens et respiratoires
Myalgies…

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4
Q

Phase plateau PRNA

A

1/3 alité, 1/3 en réa et 1/3 peuvent marcher
Atteint nerfs crâniens frequente mais rarement oculomoteurs
Aréflexie, ataxie..

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5
Q

Récupération PRNA

A

Dans l’ordre inverse d’apparition des déficits

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6
Q

Formes cliniques PRNA

A

Sd Guillain Barre demyelinisant sensitivomoteur avec risque intubation
AMAN (atteinte axonale) svt post diarrhéique

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7
Q

Bilan complications PRNA

A

RT, GDS, ECG

Systématique

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8
Q

Bilan PRNA

A

EMG et PL
NFS, coag, BR et BH, GAJ
Sero VIH, VHC, VHB, VHA, Lyme, TPHA-VDRL, CMV, EBV, campylobacter jejuni si diarrhées

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9
Q

EMG atteinte demyelinisante dans PRNA

A

↘️ des vitesses de conduction motrices et sensitives
↗️ latences distales
+/- blocs de conduction

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10
Q

EMG atteinte axonale PRNA

A

↘️amplitude des potentiels sensitifs et réponses motrices avec vitesses de conduction conservées

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11
Q

PL PRNA

A

Peut être normale !!

Hyperproteinorachie et cellules<10/mm3

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12
Q

Pronostic - PRNA

A

> 60ans, phase accélération longue, atteinte faciale bilatérale initiale, inexcitabilité nerveuse a l’EMG

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13
Q

Pec PRNA

A

Intérêt tt précoce ++++
Ig polyvalentes ou échanges plasmatiques
HBPM, kine respi et motrice, protection oculaire…

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14
Q

Corticoïdes dans PRNA

A

Pas d’intérêt

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