Guillain Barre Syndrome Flashcards
What is GBS?
acute inflammatory demyelinating polyneuropathy
Describe the aetiology of Guillain-Barre syndrome
Cross-reaction of antibodies with gangliosides in the peripheral nervous system
Anti-ganglioside antibodies (anti-GM1) in 25% of patients
40% idiopathic
List 3 non-idiopathic causes of GBS
Post-infection (1-3w): often URTI or GI
Malignancy: e.g. lymphoma
Post-vaccination
Which infection is commonly implicated in GBS?
Campylobacter jejuni
Describe the epidemiology of Guillain-Barre syndrome
UK incidence: 1-2/100,000
Affects all age groups
Give 4 common symptoms experienced in GBS
Initial back/ leg pain
ASCENDING symmetrical limb weakness (lower > upper)
Reflexes reduced/ absent
Mild ascending paraesthesia
How else may GBS manifest?
Respiratory muscle weakness
CN involvement: diplopia, bilateral facial nerve palsy, oropharyngeal weakness
Autonomic involvement: urinary retention, diarrhoea
Give 1 less common finding in GBS on fundoscopy
Papilloedema
Thought to be secondary to reduced CSF resorption
Give 2 signs of GBS on motor examination
Hypotonia
Arreflexia (ascending upwards from feet to head)
What is seen in GBS on sensory examination?
Impairment of sensation in multiple modalities (ascending from feet to head)
In GBS what may arise due to paralysis of respiratory muscles? What signs may indicate this?
Type 2 respiratory failure
CO2 flap
Bounding pulse
Drowsiness
Why should you assess postural blood pressure change and arrhythmias in GBS?
To assess Autonomic Function
What may be found on lumbar puncture in GBS?
HIGH protein
NORMAL cell count + glucose
What may be found on Nerve Conduction Study in GBS?
Decreased motor nerve conduction velocity (due to demyelination)
Prolonged distal motor latency
Increased F wave latency
May be normal in early stages of disease
Name a rare variant of GBS, and list 3 symptoms of this
Miller-Fisher:
Ophthalmoplegia (eyes affected 1st)
Ataxia
Arreflexia
