Guillain Barre syndrome Flashcards
What is Guillain Barre syndrome?
An ascending inflammatory demyelinating polyneuropathy that causes symmetrical limb weakness and parasthesia.
What causes Guillain Barre syndrome?
- often occurs 1-3 weeks after infections (e.g. EBC, CMV, campylobacter)
- 40% are idiopathic
How does Guillain Barre syndrome present?
- progressive ascending symmetrical limb weakness
- ascending paraesthesia ( or neuropathic pain)
- lower motor neurone signs on examination
- if severe may affect respiratory muscles
- may also have symptoms of cranial nerve palsies - e.g. diplopia, facial droop
What are the signs of a lower motor neurone lesion?
- hypotonia
- flaccid paralysis
- areflexia
What are the signs of a upper motor neurone lesion?
- hypertonia (increased tone)
- rigid paralysis
- hyperreflexia
What signs may be seen on examination in Guillain Barre syndrome?
- lower motor neurone signs
- paraesthesia / peripheral neuropathy
- cranial nerve signs may be seen
- there may be signs of type 2 resp failure (e.g. CO2 flap, bounding pulse)
- autonomic dysfunction may be seen (e.g. arrythmias, abnormal / labile BP)
What antibodies are associated with Guillain Barre syndrome?
Anti-ganglioside antibodies
How is Guillain Barre syndrome managed?
- conservative - monitor + aid ventilation
- reduce VTE risk as immobile
Medical management - IV immunoglobulins
- or plasmapheresis
In severe cases may require intubation + ICU care.
How is Guillain Barre syndrome diagnosed?
Diagnosed using the Brighton criteria (we don’t need to know) - based on symptoms
- can do nerve conduction studies (reduced)
- lumbar puncture - shows a raised protein with normal cell count and glucose
What is the prognosis of GBS?
- 80% full recover
- 15% left with some neurological disability
- 5% mortality
