Guillain-Barre Syndrome (GBS)

Question 1

What is GBS?

Answer 1

Temporary inflammation and demyelination of the peripheral nerves (myelin sheaths)

Question 2

Etiology?

Answer 2

Exact etiology is unknown

Hypothesized to be an autoimmune response to a previous:
- respiratory infection
- influenza
- surgery
- vaccinations
- Epstein-Barr Syndrome

Question 3

Signs and Symptoms

Answer 3

Motor weakness in a (Distal to Proximal) fashion

“The Three D’s”
- Absence of DTRs
- Dysarthria
- Dysphagia

Question 4

When does the level of disability peak?

Answer 4

2-4 weeks after onset

Question 5

Treatment

Answer 5

Medical Management:
- Hospitalization

Pharmacological Management:
- immunosuppressive medications
- analgesic/narcotic medications

-Plasmapheresis

Question 6

What is the another term for Guillain-Barre Syndrome

Answer 6

Acute Polyneuropathy

Question 7

What is the “peak frequency” of GBS? (age range)

Answer 7

Young Adults

and

Adults between their 5th and 8th decades

Question 8

What is the distribution pattern of motor weakness?

Answer 8

Distal to Proximal

Question 9

Is the motor weakness Symmetrical or Asymmetrical?

Answer 9

Distal Symmetrical Motor Weakness

Question 10

How long does recovery typically take in post GBS?

Answer 10

Gradual recovery in months to years

Question 11

What laboratory or imaging studies would confirm diagnosis?

Answer 11

CSF sample: containing high protein levels and little to no lymphocytes

Electromyography: resulting in abnormal and slowed nerve conduction

Question 12

During the acute stage of GBS, 30% of patients require what intervention?

Answer 12

Mechanical Ventilation

Question 13

Upon admission to a hospital what should PT focus on?

Answer 13

• passive ROM
• positioning
• light exercise

Question 14

What should a PT avoid during the acute stage of GBS?

Answer 14

overexertion and fatigue, to avoid exacerbation of symptoms

Question 15

What will patients typically initially present with?

Answer 15

Patient will initially present with a distal symmetrical motor weakness

Question 16

What sensory impairment may a patient present with?

Answer 16

Sensory impairments
- mild distal sensory impairments
- Transient Paresthesia’s.

Question 17

What can be life threatening for patients with GBS?

Answer 17

Respiratory paralysis
- can be life threatening

Question 18

Which gender is mostly affected?

Answer 18

Males

Question 19

Which race is GBS more likely in? Caucasians or Africans Americans?

Answer 19

Caucasians

Question 20

In which fashion does recovery usually follow?

Answer 20

Proximal to Distal