Guillain-Barre Syndrome

Question 1

GBS definition

Answer 1

• Symmetrical ascending peripheral weakness
• A group of predominately demyelinating diseases of the peripheral nerves causing acute progressive weakness, usually an ascending paralysis. Divided into 2 forms: demyelinating and Miller-Fisher syndrome

Question 2

etiology of GBS?

Answer 2

Campylobacter/flu vaccine can cause this, Abs made from this may attack the myelin sheath thinking it is campylobacter
“iphone charger gets Guillain barre”

Question 3

how to dx GBS and what will you see?

Answer 3

• lumbar puncture

- normal cell count with very high protein

Question 4

what is contraindicated with GBS?

Answer 4

prednisone

Question 5

demyelinating type

Answer 5

Acute inflammatory demyelinating polyradiculoneuropathy: >90% of cases in Western countries; 30% of patients have nonspecific elevated anti-GM I antibodies

Question 6

Miller-Fisher syndrome

Answer 6

Ophthalmoplegia,
Areflexia and ataxia of limbs with relatively preserved muscle strength; 90% of patients have elevated anti-GQ1b antibodies

Question 7

earliest symptoms of GBS?

Answer 7

Dysesthesias, paresthesias of feet and hands

Question 8

PE findings for GBS?

Answer 8

• Acute, symmetric, and usually ascending weakness of limbs within days of dysesthesias
• Gait disorder common in all age groups; most common presentation in children

Question 9

how to test for GBS?

Answer 9

-Serum anti-GM1 antibody titer

Question 10

most sensitive test for GBS?

Answer 10

nerve conduction study

Question 11

how to treat GBS?

Answer 11

• possible ventilation once it hits the diaphragm
• Immune globulin IV or plasmaphoresis for all patients too weak to walk, rapid progression, or poor prognostic indicators

Question 12

3 phases of the illness?

Answer 12

initial-24 hours-3 weeks…most dangerous
plateau-same as initial length
recovery phase 1-6 months