Guillan Barree Syndrome Flashcards
What is GBS
a disorder of demyelination and axonal degeneration leading to progressive neuropathy –> tingling, paraesthesia, weakness and hyporeflexia
What are the triggers for GBS
Viruses: CMV, Epstein Barr, Mycoplasma, HIV
Camplyobacter jejuni
infection is normally 1-3 weeks before onset of weakness
What are the clinical features of GBS
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
What are the differentials for GBS
MS –> more likely to be focal
Stroke –> more likely to affect one side
Peripheral nerve disease –> diabetic neuropathy
Myaesthenia gravis –> no neuropathy
Hypokalaemia
Which investigations should you do in GBS
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
Why do a CXR in suspected GBS
To rule out small cell lung cancer with paraneoplastic syndrome - Lambert Eaton Syndrome –>autonomic dysfunction
What is the treatment for GBS
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
What is the prognosis like
usually good most patients make a fully recovery
What are the complications of GBS
Paralysis --> increases risk of DVT Resp failure --> pneumonia hypotension or hypertension aspiration pnemonia paralytic ileus Urinary retention --> UTI
Should prophylactic warfarin or dalteparin be prescribed in GBS
If paralysis as patient will be immobile so at increased risk of DVT
