Guillain-Barre Syndrome

Question 1

What is it?

Answer 1

Acute paralytic polyneuropathy affecting the peripheral nervous system causing acute symmetrical ascending weakness

Question 2

What is it associated with?

Answer 2

Campyolobacter jejuni
CMV
EBV

Question 3

Explain the pathophysiology

Answer 3

B cells create abs against the antigens on the triggering pathogen
These abs match proteins on the peripheral neurones

Question 4

How does it present? What is the progress

Answer 4

Start within 4 weeks of triggering infection
Begin in the feet and progress upwards
with symmetrical ascending weakness and reduced reflexes
Loss of sensation or neuropathic pain
Facial weakness
Autonomic dysfunction - urinary retention, ileus or arrhythmias

Question 5

What criteria are used to diagnose?

Answer 5

Brighton criteria

Question 6

What investigations?

Answer 6

Nerve conduction studies - reduced signal
LP - raised protein and normal cell count and glucose

Question 7

What is management?

Answer 7

IVIg
VTE - PE is leading cause of death
Plasmapharesis is an alternative to IVIg

Question 8

What is the prognosis?

Answer 8

Recovery over months or years
Most have a full recovery or minor sx
Some left with significant disability