Guillain-Barre Syndrome

Question 1

What is Guillain-Barre syndrome?

Answer 1

An acute inflammatory demyelinating polyradiculoneuropathy

Question 2

What is this a presentation of?
Recent infection, symmetrical ascending proximal muscle weakness. Sweating, labile BP and pulse, arrhythmias, bowel and bladder symptoms. Back and limb pain. Sensory symptoms, reflexes lost early.

Answer 2

Guillain-Barre syndrome

Question 3

What are the triggers for Guillain-Barre syndrome?

Answer 3

Campylobacter jejuni, CMV, HIV, EBV, vaccinations (no cause found in 40%)

Question 4

How is suspected Guillain-Barre syndrome investigated?

Answer 4

1. Routine bloods (including HIV)
2. Nerve conduction studies - slow conduction
3. CSF - raised protein, normal WCC
4. FVC 4 hourly and ventilate if respiratory compromise
5. Cardiac monitoring for arrhythmias

Question 5

What is the treatment for Guillain-Barre syndrome?

Answer 5

1. IVIg (NO STEROIDS)
2. Plasma exchange
3. Anticoagulation - increased VTE risk