Guillan Barree Syndrome Flashcards

1
Q

What is GBS

A

a disorder of demyelination and axonal degeneration leading to progressive neuropathy –> tingling, paraesthesia, weakness and hyporeflexia

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2
Q

What are the triggers for GBS

A

Viruses: CMV, Epstein Barr, Mycoplasma, HIV
Camplyobacter jejuni
infection is normally 1-3 weeks before onset of weakness

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3
Q

What are the clinical features of GBS

A

history of infection
Weakness tends to be in the lower limbs and move upwards
Lower motor neurone signs
Facial weakness
dysphasia
dysarthria
Muscle weakness –> may lead to respiratory failure
Neuropathic pain
Autonomic symptoms –> reduced sweating, reduced heat tolerance, paralytic ileus, urinary hesitancy

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4
Q

What are the differentials for GBS

A

MS –> more likely to be focal
Stroke –> more likely to affect one side
Peripheral nerve disease –> diabetic neuropathy
Myaesthenia gravis –> no neuropathy
Hypokalaemia

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5
Q

Which investigations should you do in GBS

A

Bloods

  • FBC
  • U+Es –> potassium to rule out hypokalaemia
  • LFTs
  • Clotting
Anti-ACh and Anti-MSK to rule out myaesthenia gravis 
CXR
LP
Respiratory function tests 
Nerve conduction studies
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6
Q

Why do a CXR in suspected GBS

A

To rule out small cell lung cancer with paraneoplastic syndrome - Lambert Eaton Syndrome –>autonomic dysfunction

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7
Q

What is the treatment for GBS

A

Similar to Myaesthenia gravis
- IV Immunoglobulins and or plasmapheresis for acute episodes
- corticosteroids to help prevent remission
Intubation and ventilation in resp failure - tracheostomy may be needed for long term management

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8
Q

What is the prognosis like

A

usually good most patients make a fully recovery

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9
Q

What are the complications of GBS

A
Paralysis --> increases risk of DVT
Resp failure --> pneumonia 
hypotension or hypertension 
aspiration pnemonia 
paralytic ileus
Urinary retention --> UTI
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10
Q

Should prophylactic warfarin or dalteparin be prescribed in GBS

A

If paralysis as patient will be immobile so at increased risk of DVT

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