Guillain Barre Syndrome Flashcards
What is Guillain-Barre syndrome?
Acute demyelinating polyneuropathy
An acute inflammatory response which most-often occurs several weeks after viral infection, usually GI/GU.
How long after infection does paralysis occur in someone with Guillain-Barre syndrome?
1-3 weeks
What are causes of Guillain-Barre Syndrome?
- Campylobacter jejuni
- CMV
- Mycoplasma
- Herpes Zoster
- HIV
- EBV
- Vaccination
Why does Guillain-Barre Syndrome occur?
Molecular mimicry, i.e. sharing of homologous epitopes between microorganism liposaccharides and nerve gangliosides (e.g. GM1), is the possible mechanism.
What are symptoms/signs of Guillain-Barre syndrome?
LMN lesion
- Symmetrical ascending muscle weakness
- Autonomic dysfunction - Sweating, tachycardia, Hypertension, arrhythmias
How long does it take for someone to enter the recovery phase of Guillain-Barre syndrome?
4-6 weeks
What proportion of those with Guillain-Barre syndrome develop respiratory and facial muscle weakness?
20%
What investigations might you do in someone with suspected Guillain-Barre syndrome?
- Nerve conduction studies
- LP
What might nerve conduction studies show in someone with Guillain barre syndrome?
Slow conduction
What might LP investigation show in someone with Guillain-Barre syndrome?
- Increased protein
- Normal WCC
- Normal Glucose
What signs may indicate need for transfer to ITU in someone with Guillain-Barre syndrome?
Respiratory involvement
How would you monitor for respiratory involvement in someone with Guillain-Barre syndrome?
4-hourly FVC
How would you manage someone with Guillain-Barre Syndrome?
- IVIG - 5 days - 2 weeks
- DVT prophylaxis - LMWH + compression stockings
- Consider Plasma exchange
What is the prognosis for someone with Guillain-Barre syndrome?
Good - 85% of individuals make near/complete recovery. Recovery takes time
