Guillain-Barre syndrome

Question 1

Guillain-Barre syndrome causes what changes to nerves?

Answer 1

demyelination
axonal degeneration
->acute, ascending, progressive neuropathy, weakness, paraesthesia, hyporeflexia

Question 2

Guillain-Barre syndrome - usual cause/precipitant

Answer 2

75% preceeded by infection - usually Campylobacter jejuni
usually at least a respiratory or GI infection
1-3 weeks before Guillain-Barre syndrome

antibodies to these bacteria then attack peripheral nerves

Question 3

Guillain-Barre syndrome presentation

Answer 3

weakness in an ascending (distal first) pattern - symmetrical
neuropathic pain might feature (legs)
reduced/absent reflexes
sensory loss/paraesthesia - ascending pattern
autonomic symptoms may feature

Facial weakness, dysphasia or dysarthria may develop.
severe cases - may lead to respiratory failure

Question 4

Guillain-Barre syndrome management

Answer 4

CSF protein
antibodies to peripheral nerves
spirometry - important to see if ICU admission is required
nerve conduction studies the most important confirmatory test

plasma exhange
IV Ig’s