Guillain Barre Syndrome

Question 1

what is GBS?

Answer 1

acute inflammatory demyelinating polyneuropathy that results in ascending paralysis. GBS is the demyelination of the peripheral nerves, incl cranial nerves that occurs in reaction to autoimmunity (normally preceded by GIT or respiratory infection

S&S:
- abrupt ascending paraesthesia with a glove and stocking pattern of sensory loss
- symmetrical muscle weakness and wasting
- decreased tone and reflexes (may affect resp)
- motor fibers more affected than sensory
- proprioception is the most affected sensory function
- all symptoms are from distal to proximal
- disturbance in autonomic function: cardiac arrythmias and unstable BP

Question 2

outline the physiotherapy management of GBS in the acute stage <day 10

Answer 2

• respiratory care
• msk; joint movement and protection
• skin; positioning and circulation
• psychological support

Question 3

outline the physiotherapy management of GBS in the recovery/plateau stage

Answer 3

• determine priorities
• chest care
• joint care
• muscle strength
• central stability (stabs, crawling, kneeling, ball)
• sensory awareness and balance re-education
• ADLs
• orthoses
• motivation and support groups

Question 4

what precautions should be taken into consideration with GBS mx?

Answer 4

• dont overstretch
• postural hypotension
• avoid fatigue (paradoxical weakeening)
• autonomic dysreflexia
• decreased sensation
• DVT
• Pain

Question 5

what nerves are most likely to have residual paralysis?

Answer 5

• median nerve
• ulnar nerve
• peroneal nerve (foot drop)
• distal branches of tibial nerves

Question 6

what is common between these nerves?

Answer 6

all pass through an entrapment:
median - carpal tunnel
ulnar - ulnar sulcus
peroneal - fibula head
tibial branches - tarsal tunnel