Guillain-Barre syndrome Flashcards
What is guillain-barre syndrome?
acute autoimmune demyelinating polyneuropathy affecting PNS
What is the patho of GB?
autoimmune process attacking myelin surrounding peripheral nerves
What is the cause of GB?
30% of cases occur after gastroenteritis infection caused by
Campylobacter jejuni
What are the inital symptoms of GB?
- Gastroenteritis, URTI (campylobacter jejuni, CMV and HIV)
2. 2-3 weeks later peripheral neuropathy
What are the peripheral neuropathy signs?
- Progresses acutely
- Ascending paraesthesia & pain
- Symmetrical limb weakness
- Hypotonia
- Flaccid paralysis
- Altered sensation/numbness
- Fasciculations
(LMN signs)
What can GB progress to?
affect respiratory muscles leading to respiratory paralysis and death
What is Miller-FIscher syndrome?
Triad of: 1. Ophthalmoplegia 2. Areflexia 3. Ataxia But NO muscle weakness
How common is Miller-Fischer syndrome?
25% GBS cases
What are possible DDx for GB syndrome?
- MG
2. Transvere myelitis
What is used for defintive diagnosis of GB?
- nerve conduction studies
- Decreased conduction velocity
What other investigations are used for GB syndrome?
- spirometry
- Lumbar puncture
- bloods
Why do you do spirometry?
Important to monitor for respiratory weakness – reduced vital capacity
What does LP show in GB?
- Increased protein
* Normal glucose & WCC
What bloods are done for GB?
Anti-ganglioside antibody in Miller-Fisher variant (25% cases)
What is conservative management for GB?
resp support + DVT prophylaxis
