Guillain-Barre Syndrome Flashcards
What is Guillain- Barré syndrome?
It is an autoimmune disorder and the underlying pathology is usually multi focal inflammation and de-myelination throughout the PNS, with secondary Axonal degeneration in the most severely affected
What is guillain Barré syndrome characterised by?
Rapidly evolving symmetrical limb weakness
Loss of tendon reflexes
Absent or mild sensory signs
Variable autonomic dysfunctions
What are the different types of GBS?
Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) - most common form, muscle weakness spreads from the lower limb upwards.
Miller fisher syndrome (MFS)- paralysis starts in the eyes
Acute motor axonal neuropathy (AMAN)
Acute motor sesnsory axonal neuropathy (AMSAN)
Signs and symptoms of GDS
Pins and needles
Weakness in the legs that spreads to the upper body
Unsteady walking or inability to walk or climb stairs
Rapid heart rate
Difficulty with eye or facial movements, including speaking, chewing or swallowing
What is the common course of disease of GDS?
Disease begins in legs and heads to upper limb
Maximum signs and symptoms at 2 weeks
Plateaus period 4-6 weeks to a year
Recovery can start from week 4 over several months
What is the physiotherapy treatment of GBS?
No evidence exists surrounding effective treatment by physio on GBS patients. However other neurological conditions similar use muscle strengthening, functional rehabilitation of walking etc.
What outcome measures would you use for a GBS patient?
Lung function tests
Oxford scale
Rom
Timed sitting
What secondary problems can occur in patients with GBS?
Joint contractures Pressure sores DVT Muscle atrophy Psychological problems
What is AIDP
Acute inflammatory demyelination polyradiculneuropathy
The immune system attacks the myelin coating which affects transmission of nerve signals
Symptoms- tingling and weakness starts from the legs and spreads to the upper body.
What is miller fishers disease
It is rare and affects the Asian population primarily- paralysis starts in the eyes. It is associated with unsteady gait
What is AMAN and AMSAN
Acute motor axonal neuropathy- AMAN
Axons are damaged by neuron defence
ACute motor sensory axonal neuropathy- AMSAN
What is GBs characterised by
Loss of tendon reflexes
Rapid evolving symmetrical limb weakness
Absent or mild sensory signs
Variable autonomic dysfunctions
What is the course of GBS
The disease is ascending so begins in legs and moves up to upper body. Maximum signs and symptoms are reached between 2-4 weeks.
15% of the people may require ventilation
More so occurs in men then women
Even with modern treatment 8% of patients die
Recovery can start from 4- several months
What is spina bifida
Congenital abnormality in the formation of the vertebral joints -
Myelomeningocele- most likely to get hyrdocephalus- csf into ventricles in the brain
meningocele - protrusion but doesn’t press on the spinal cord
Occulta- no protrusion
