Guillain Barre syndrome

Question 1

Define Guillain Barre syndrome

Answer 1

GBS is an autoimmune, acute, inflammatory, demyelinating polyneuropathy characterised by progressive, ascending loss of sensation.

Question 2

What is Guillain Barre syndrome the equivalent of?

Answer 2

MS but in the PNS

Question 3

What are the risk factors of Guillain Barre?

Answer 3

• Males 15-30, 50-70
• Most common acute polyneuropathy
• 85% recover good prognosis

Question 4

What are the causes of Guillain Barre?

Answer 4

• Campylobacter jejuni (most common) –> gastroenteritis typically precedes GBS
• Viruses (CMV, EBV, HZV)

Question 5

Describe the pathophysiology of Guillain Barre

Answer 5

Molecular mimicry:
- Organism antigens are similar to those on Schwann cells
- Results in antibody production against Schwann cells –> demyelination + acute polyneuropathy

Question 6

What are the symptoms of Guillain Barre?

Answer 6

Triad of
- Progressive symmetrical muscle weakness (+paralysis)
- Reduced or absent tendon reflexes
- Reduced sensation

Question 7

What investigations do you do for GB?

Answer 7

• Nerve conduction studies
• LP
• EMG (Electromyography)

Question 8

What is seen on nerve conduction studies?

Answer 8

Decreased conduction or block

Question 9

What is seen on LP for GB?

Answer 9

Raised protein + normal WCC
(= inflammation, no infection)

Question 10

What is the treatment for GB?

Answer 10

• IV Ig for 5 days + plasma exchange

Question 11

What has to be monitored in GB?

Answer 11

Breathing rate as there is a risk of respiratory distress