Guillain Barre syndrome

Question 1

What is Guillain Barre?

Answer 1

Guillain-Barre syndrome (GBS) is a type of acute inflammatory neuropathy.

Question 2

What are the risk factors for Guillain Barre?

Answer 2

> preceding viral illness
preceding bacterial infection
preceding mosquito-borne viral infection
hepatitis E infection

Question 3

What are the signs and symptoms of Guillain Barre?

Answer 3

It is a clinically defined syndrome characterised by motor difficulty, absence of deep tendon reflexes, paraesthesias without objective sensory loss, and increased CSF albumin with absence of cellular reaction (albuminocytological dissociation).

Motor and sensory difficulty includes:
> Weakness, Dysarthria, dysphagia, dysautonomia, diplopia, drooped face, oropharyngeal weakness
> Parasthesia, pain

Question 4

What is the epidemiology of Guillain Barre?

Answer 4

Population-based studies give crude mean annual incidence rates varying from 0.6 to 1.9 per 100,000 population.

Question 5

What investigations would you do for Guillain Barre?

Answer 5

> Nerve conduction studies (slow)
Lumbar Puncture (elevated protein in CSF/ WBC)
LFTs (high AST/ ALT)
Spirometry (reduced VC and pressure)
Antiganglioside antibodies (Acute neuropathy markers)