Guillain-Barre syndrome

Question 1

PNS or CNS

Answer 1

PNS

Question 2

Definition

Answer 2

Rare PNS disorder

Peripheral nephropathy (damage to axons of peripheral nerves)

Polyneuropathy (lots of PNs compromised)

Question 3

Aetiology and pathophysiology

Answer 3

Abnormal immune response
antibodies and WBS attack myelin of peripheral nerve -> demyelination of peripheral nerves

leads to reduced or absent nerve conduction

Question 4

How is it diagnosed

Answer 4

1. lumbar puncture testing CSF (high levels +)
2. Nerve conduction study (NCS) or EMG
   - abnormal nerve conduction

Question 5

Typical initial presentation

Answer 5

• relatively fast onset (peak at 4/52)
• bilateral
• LL weakness

Question 6

Problems

Answer 6

Bilateral - LL, UL, trunk and face/head

Sensory - somatosensory - tingling

Motor (LMNs)

• paresis
• abnormal muscle tone: hypotonia/flaccidity
• abnormal reflexes: hyporeflexia/areflexia

Question 7

Management

Answer 7

1. Plasmapheresis (plasma-exchange)

2. immunoglobulin therapy -> improve immune system and reduce autoimmune response