Guillain Barre Flashcards
What investigations should be done for acute weakness?
FBC
U and Es
LFTs, Ca, phosphate, magnesium
CRP, ESR
What is Guillain Barre?
Peripheral neuropathy affecting nerve roots, peripheral nerves and NMJ
Gives ascending paralysis
What CSF result does GBS give?
Cytoalbuminologic dissociation
Normal cell count
Elevated protein
What are the differentials for breathlessness in GBS?
Chest infection
PE
Neuromuscular ventilatory failure
What are some differentials for GBS?
Transverse myelitis
Myasthenia gravis
Botulism
Vasculitic neuropathy
What can often precede GBS?
Campylobacter infection
What other systems can GBS affect?
Respiratory - neuromuscular ventilatory failure
Autonomic - labile BP, arrhythmias, constipation, abdominal distension
Facial nerves
Ophthalmoplegia
How is GBS treated?
IV immunoglobulin 0.4g/kg/day for 5 days
Thromboprophylaxis
Respiratory monitoring - FVC
When should intensive care be called in GBS?
Alert to patient when admitted
If FVC drops below 1L
What are some of the other triggers for GBS?
EBV, CMV, HIV
Hodgkin’s, CLL
E coli
Pregnancy, surgery
What is the prognosis of GBS?
80% recover within 6 months
15% severe disability
