Guillain Barre Syndrome

Question 1

Definition

Answer 1

Autoimmune.
Postinfectious peripheral neuropathy.
Presents 2-3 weeks after respiratory(Mycoplasma pneumonia) or gi(Campylobacter jejuni) infection.

Question 2

S&S

Answer 2

Motor :
Ascending symmetrical progressive weakness.
Areflexia and hypotonia.
Bulber palsy : dysphagia, dysphonia, dysarthria, absent gag reflex.
Respiratory muscles : respiratory failure.

Sensory :
Numbness or paresthesia in hands and feet.

Autonomic :
BP and HR changes.
Urinary incontinence or retention.
Stool retention.

Question 3

Miller - Fisher Syndrome

Answer 3

Variant of Guillain Barre Syndrome.

Ataxia, Partial ophthalmoplegia, Areflexia

Question 4

Investigations

Answer 4

CSF :
Sometimes normal early.
High protein, without significant pleocytosis.

MRI :
Of the spinal cord is the most accurate acutely.
Reveal enhancement of the spinal nerve roots.

Question 5

TTT

Answer 5

IVIG
Alternatives : plasma exchange and immunosuppressive.
ETT in case of respiratory failure or inability to clear secretions.

Question 6

Prognosis

Answer 6

80% recover normal function.
Others left with residual weakness.
Improvement usually follows the opposite direction of involvement.