Guillain Barre Syndrome Flashcards
What is GBS?
acute inflammatory demyelinating polyneuropathy
Describe the aetiology of Guillain-Barre syndrome
Antibodies after a recent infection react with self-antigen on myelin or neurons causing inflammation
40% idiopathic
List 3 non-idiopathic causes of GBS
Post-infection (1-3w): often URTI or GI
Malignancy: e.g. lymphoma
Post-vaccination
Describe the epidemiology of Guillain-Barre syndrome
UK incidence: 1-2/100,000
Affects all age groups
Describe the symptoms experienced in GBS
PROGRESSIVE Sx < 1 month duration of:
ASCENDING symmetrical limb weakness (lower > upper)
ASCENDING paraesthesia
Cranial nerve involvement (leading to dysphagia, dysarthria, facial weakness)
Respiratory muscles affected in severe cases
List 3 signs of GBS on motor examination
Hypotonia
Flaccid paralysis
Arreflexia (ascending upwards from feet to head)
What is seen in GBS on sensory examination?
Impairment of sensation in multiple modalities (ascending from feet to head)
What cranial nerve palsies may be seen in GBS?
Facial nerve weakness (LMN pattern)
Abnormality of external ocular movements
If pupil constriction is affected, consider botulism
In GBS what may arise due to paralysis of respiratory muscles? What signs may indicate this?
Type 2 respiratory failure
CO2 flap
Bounding pulse
Drowsiness
Why should you assess postural blood pressure change and arrhythmias in GBS?
To assess Autonomic Function
What may be found on lumbar puncture in GBS?
HIGH protein
NORMAL cell count + glucose
Name a rare variant of GBS, and list 3 symptoms of this
Miller-Fisher = ophthalmoplegia, ataxia, arreflexia
What may be found on Nerve Conduction Study in GBS?
Reduced conduction velocity +/- conduction block
May be normal in early stages of disease
What may be found in the blood in GBS?
Anti-ganglioside antibodies in Miller-Fisher variant + 25% of Guillain-Barre cases
What may be found on spirometry in GBS?
Reduced fixed vital capacity: suggests ventilatory weakness
