Guillain Barre Flashcards
Definition
Acute inflammatory polyradioloneuropathy that affects the axons or myelin of the peripheral nervous system, causing motor and sensory abnormalities
Ascending paralysis
Starts at the toes and works its way up
Associated with
Campylobacter jejuni
Influenza
Epstein-Barr
Cytomegalovirus
Not sufficient to establish a diagnosis, but often reported….
Surgery
Trauma
Pregnancy
Vaccines
Healing occurs in reverse
Neurons affected last are the first to recover
Acute period
1-4 weeks
Plateau period
Several days to 2 weeks
Recovery phase
4-6 months or 2 years
Motor manifestations
Ascending symmetric muscle weakness Decreased or absent DTR Respiratory compromise Loss of bowel:bladder control Ataxia
Sensory manifestations
Paresthesias
Pain
Cranial nerve manifestations
Facial weakness
Dysphagia
Diplopia
Difficulty speaking
Autonomic manifestations
Labile blood pressure
Cardiac dysrhythmias
Tachycardia
Cranial nerves to check
5 7 10 11 12 9
Lumbar puncture
Increased protein
May not show until 1-2 weeks
Peaks after 4-6 weeks
Normal lymphocyte
Electrophysiologic studies
Electrical conduction of heart shows demylunated neuropathy
Electromyographic
Peripheral nerve function
Normal early, abnormal 4-6 weeks later
Priority nursing care
Respiratory
Suction at bedside
Swallowing?
Drooling?
HOB 45
Pain management
Opioid
Tricyclics
Gabapentin
CAM therapies
CT and MRI
Rule out other possibilities
Treatment
Plasmapheresis
OR
Immunoglobulin IV
Plasmapheresis
Removes circulating antibodies blamed
Immunoglobulin therapy
Just as effective
May cause
Fever, chills, HA
Meningitis, anaphylaxis
Complications of plasmapheresis
Hypocalcemia Depleted coagulopathy Infection Hypovolemia Anaphlaysis Clotting at site Bleeding
