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Year Two - Neurology System > Guillain Barre Syndrome > Flashcards

Guillain Barre Syndrome Flashcards

1
Q

What is Guillain Barre syndrome?

A

It is defined as an immune mediated demyelination of the peripheral nervous system, resulting in an acute paralytic polyneuropathy

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2
Q

What is the cause of Guillain Barre syndrome?

A

Infection

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3
Q

What three infections are most commonly associated with Guillain Barre syndrome?

A

Campylobacter jejuni

Cytomegalovirus

Epstein Barr virus

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4
Q

What is the most common infection that causes Guillain Barre syndrome?

A

Campylobacter jejuni

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5
Q

Describe the pathophysiology of Guillain Barre syndrome

A

It is thought to occur due to molecular mimicry, in which immune B-cells create antibodies against infectious antigens that cross-match with the ganglioside proteins located on nerve cells

This means that the anti-ganglioside antibodies (anti-GM1) can target the myelin sheath of the motor nerve cell or the nerve axon itself

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6
Q

What cells are affected in Guillain Barre syndrome?

A

Schwann cells

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7
Q

What hypersensitivity reaction occurs in Guillain Barre syndrome?

A

IV

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8
Q

What are the eight clinical features of Guillain Barre syndrome?

A

Progressive, Ascending, Symmetrical Flaccid Weakness (Legs - Arms)

Hyporeflexia

Neuropathic Back/Leg Pain

Respiratory Muscle Weakness

Distal Paraesthesia

Urinary Retention

Gastroenteritis Features

Cranial Nerve Involvement

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9
Q

What are the two features gastroenteritis in Guillian Barre syndrome?

A

Diarrhoea

Vomiting

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10
Q

What are the three features of cranial nerve involvement in Guillain Barre syndrome?

A

Diplopia

Bilateral facial nerve palsy

Oropharyngeal weakness

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11
Q

How long do the clinical features of Guillain Barre syndrome take to occur following infection?

A

4 weeks

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12
Q

How long does it take for the clinical features of Guillain Barre syndrome to peak?

A

2-4 weeks

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13
Q

In most cases how is Guillain Barre syndrome diagnosed?

A

Clinically

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14
Q

What criteria is used to assist in the clinical diagnosis of Guillain Barre syndrome?

A

Brighton criteria

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15
Q

What two investigations are used to confirm a diagnosis of Guillain Barre syndrome?

A

Lumbar puncture

Nerve conduction studies

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16
Q

What is a lumbar puncture?

A

It involves the insertion of a needle into the subarachnoid space of the spinal cord, specifically between L3 and L4 vertebrae, to collect a sample of CSF

17
Q

What is the sign of Guillain Barre syndrome on lumbar puncture?

A

Albuminocytologic dissociation

18
Q

What is albuminocytologic dissociation?

A

This is when there are increased protein levels, with a normal white blood cell count and glucose levels

19
Q

What are nerve conduction studies?

A

They measure how fast an electrical impulse is transmitted through the nerve

20
Q

What are the three signs of Guillain Barre syndrome on nerve conduction studies?

A

Decreased Motor Nerve Conduction Velocity

Prolonged Distal Motor Latency

Increased F Wave Latency

21
Q

What is the most appropriate management step in suspected cases of Guillain Barre syndrome?

A

Secondary Care Admission

22
Q

When do we need to supportively manage Guillain Barre syndrome?

A

In severe cases, where respiratory failure develops

23
Q

How do we supportively manage Guillain Barre syndrome?

A

Intubation

Ventilation

ITU Admission

24
Q

What are the three pharmacological management options for Guillain Barre syndrome?

A

IV Immunoglobulins

Plasma Exchange

VTE Prophylaxis

25
Q

How long can the recovery period last in Guillain Barre syndrome?

A

Months to years

26
Q

What percentage of patients fully recover from Guillain Barre syndrome?

A

80%

27
Q

What percentage of patients are left with neurological disability from Guillain Barre syndrome?

A

15%

28
Q

What percentage of patients die from Guillain Barre syndrome?

A

5%

29
Q

What is the most common cause of death in Guillain Barre syndrome?

A

Pulmonary embolism

30
Q

What is Miller Fisher syndrome?

A

It refers to a variant of Guillain Barre syndrome, in which anti-ganglioside Q1b antibodies are formed

31
Q

What are the four clinical features associated with Miller Fisher syndrome?

A

Ophthalmoplegia

Areflexia

Ataxia

Descending Muscle Weakness (Arms - Legs)

32
Q

What muscles are affected first in Miller Fisher syndrome?

A

Eye muscles

Year Two - Neurology System (25 decks)

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