Guillain-Barre Syndrome Flashcards

1
Q

What is GBS?

A

immune-mediated demyelination of the peripheral nervous system often triggered by an infection

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2
Q

What infection classically triggers GBS?

A

Campylobacter jejuni
=> may be a history of gastroenteritis

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3
Q

Describe the pathogenesis of GBS

A

cross-reaction of antibodies with gangliosides in the peripheral nervous system

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4
Q

What antibody can be found in 25% of patients with GBS

A

anti-GM1 antibodies

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5
Q

Variant of Guillain-Barre syndrome
associated with ophthalmoplegia, areflexia and ataxia

A

Miller Fisher syndrome

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6
Q

Describe the pattern of disease onset in Miller Fisher syndrome compared to GBS

A
  • eye muscles are typically affected first
  • presents as a descending paralysis rather than ascending
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7
Q

Antibodies found in Miller Fisher syndrome

A

anti-GQ1b antibodies

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8
Q

Clinical features of GBS

A
  • ascending weakness (legs first)
  • reflexes reduced/absent
  • sensory symptoms are mild (e.g. distal paraesthesia)
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9
Q

Less common features of GBS

A
  • respiratory muscle weakness
  • CN involvement (diplopia, facial nerve palsy, oropharyngeal weakness)
  • urinary retention
  • diarrhoea
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10
Q

Investigations

A

LP
nerve conduction studies

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11
Q

CSF findings in GBS

A

high protein
normal white blood cell count (albuminocytologic dissociation)

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12
Q

Nerve conduction study findings

A
  • decreased motor nerve conduction velocity (due to demyelination)
  • prolonged distal motor latency
  • increased F wave latency
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13
Q

Management of GBS

A

IV immunoglobulins (IVIG) or plasma exchange

FVC regularly to monitor respiratory function

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14
Q

Poor prognostic features

A
  • age > 40 years
  • poor upper extremity muscle strength
  • Hx of a diarrhoeal illness (specifically Campylobacter)
  • high anti-GM1 antibody titre
  • need for ventilatory support
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15
Q
A
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