Guillain-Barré Syndrome

Question 1

Define Guillain-Barré syndrome

Answer 1

Acute inflammatory demyelinating polyneuropathy

Miller Fisher – GBS variant with ophthalmoplegia, ataxia and arreflexia

Question 2

What are the causes/risk factors of Guillain-Barré syndrome?

Answer 2

Cross reactive antibodies attack myelin sheath of Schwann cells after infection
• Idiopathic
• Post-infection (1-3 weeks)
- Campylobacter jejuni
- HIV
- Herpes zoster
- CMV
• Malignancy e.g. lymphoma
• Post-vaccination

Question 3

What are the symptoms of Guillain-Barré syndrome?

Answer 3

• Ascending symmetrical limb
weakness/paralysis
• Ascending paraesthesia
• Respiratory distress
• Speech difficulties
• Dysphagia
• Diplopia

Question 4

What are the signs of Guillain-Barré syndrome?

Answer 4

• Hypotonia
• Flaccid paralysis
• Arreflexia
• Paraesthesia
Cranial nerve palsies
• Facial weakness/droop
• Abnormal eye movements
• Bulbar palsy – dysarthria
T2RF
• CO2 flap
• Bounding pulse
• Drowsiness

Question 5

What investigations are carried out for Guillain-Barré syndrome?

Answer 5

• Lumbar Puncture - elevated CSF Protein
-Cell count and glucose Normal
• Nerve Conduction Studies - reduced conduction velocity or conduction block, but can be normal in the early phase of the disease.
• Spirometry - may show reduced vital capacity, maximal inspiratory pressure, or maximal expiratory pressure
• Antiganglioside Antibody - positive in Miller-Fischer GBS.
• Serology - may indicate causative infection.
• ABG - type 2 Respiratory Failure
• ECG - arrhythmia