Guillain-Barre Syndrome Flashcards
GBS is the most common cause of what?
acute neuromuscular paralysis
what are the 4 characteristics of GBS?
symmetric
ascending
autoimmune inflammation
peripheral nerves
what does a patient with GBS usually have a history of?
upper respiratory or GI infection 2-4 weeks ago
what infection is most commonly associated with GBS?
campylobacters jejuni enteritis
what is the pathogenesis of GBS?
infection/trauma causes immune response that is directed at myelin of peripheral nerves (demyelination occurs)
what do the antibodies attack to cause demyelination of peripheral nerves?
node of Ranvier
OR
Schwann cell
what is often the first noticeable symptom of GBS?
gait disturbance
what 5 autonomic dysfunctions can occur that can be life threatening?
cardiac irregularities
hypo/hypertension
facial flushing
sweating abnormalities
pulmonary dysfunction
what are 2 things notable on physical exam?
diminished/absent reflexes
symmetric weakness
what is the symptomatic nadir for most patients with GBS?
up to 4 weeks of symptom onset
what are 2 mandatory diagnostics?
lumbar puncture
neurophysiology studies
what will the CSF look like to diagnose a patient with GBS?
elevated protein with normal WBC count (albuminocytological dissociation)
how long can CSF take to present + for GBS?
2-3 weeks
which diagnostic is the most specific and sensitive for diagnosing GBS?
electromyography (EMG)
what is the general treatment for GBS? (3)
vigilant supportive care:
pain control
DVT prophylaxis
low dose heparin
what 2 medications can be used to treat neuropathic pain associated with GBS?
gabapentin
carbamazepine
what are 2 treatment options available to patients and what are their jobs?
plasmapheresis - removes circulating antibodies
IVIG - neutralizes antibodies/inflammation
what is NOT recommending in patients with GBS?
glucocorticoids
in which patients is treatment with plasmapheresis or IVIG recommended? (2)
nonambulatory adult patient within 4 weeks of symptom onset
ambulatory adult patient not recovering within 4 weeks of symptom onset
what is the prognosis of GBS?
function returns slowly over weeks-months
what is the treatment for relapses with increased weakness?
plasmapheresis or IVIG
