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Neuro Rehab > Guillian Barre > Flashcards

Guillian Barre Flashcards

1
Q

what is GB also known as

A

acute inflammatory demyelinating polyneuropathy

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2
Q

pathology of GBS

A

autoimmune disorder that destroys myelin sheath surrounding peripheral nerves

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3
Q

what typically precedes GBS

A

2/3 cases have an infection 2 weeks prior to GBS onset

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4
Q

what infections typically precede GBS

A

upper respiratory or GI

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5
Q

what percentage of cases have idiopathic origins

A

27

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6
Q

what are the 4 distinct phases of GBS

A

latency
progression
plateau
recovery

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7
Q

latency phase definition

A

between onset of preceding illness and neuropathic symptoms

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8
Q

progression phase definition

A

onset of symptoms until nadir
- point in which symptoms are most severe

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9
Q

plateau phase definition

A

period of weakness

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10
Q

clinical motor manifestations of GBS

A

symmetrical ascending loss of motor function

reduced deep tendon reflexes

can involve respiratory / oral muscles

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11
Q

in _____% of cases, mechanical ventilation may be indicated due to _____

A

20-30%

paresiss/paralysis of diaphragm and intercostal musculature

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12
Q

sensory clinical manifestations of GBS

A

distal hyperesthesias, paresthesias, numbness

decreased proprioception

stocking-glove

cramping pain

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13
Q

explain stocking and glove pattern

A

not a dermatomal pattern, more global
– ie entire foot and hand

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14
Q

autonomic clinical manifestation of GBS

A

low cardiac output
arrythmias
BP fluctuations
peripheral pooling of fluid
urinary retention

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15
Q

which gender is GBS seen more in

A

males

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16
Q

what percentage of patients reach symptom nadir in 1-3 weeks from onset

A

50

17
Q

explain recovery rate of GBS

A

gradual recovery of strength 2-4 wks after plateau

about 80% are ambulatory within 6 months of symptom onset

18
Q

explain % of cardiac event death in those with GBS

A

3-5%

19
Q

what are the most common residual deficits seen in GBS

A

foot drop
facial weakness
hand atrophy
sensory ataxia
dyesthesia

20
Q

what is dyesthesia

A

abnormal sensation that is unpleasant and can be pain-like

21
Q

how is the diagnosis of GBS completed

A

clinical presentations
CSF sampling
EMG
nerve conduction velocity testing

22
Q

when one is diagnosed with GBS, what immediately occurs? why?

A

hospitilization due to risk of respiratory compromise

23
Q

what are the options for medical management of GBS

A

Plasmapheresis
IV immunoglobulin

24
Q

what is plasmapheresis

A

removal of plasma from blood to remove antibodies from blood stream

25
Q

what is IV immunoglobulin treatment

A

injection of proteins that interrupt myelin destruction

26
Q

during evaluation, what major system should be focused on? when should this be checked?

A

cardiopulm system review
before, during and after exercise

27
Q

motor exam during GBS eval should include

A

oculomotor
facial muscles
cranial nerve
grip strength

28
Q

what areas are at risk of pressure breakdown in those with GBS

A

feet - bottom specifically
hands

29
Q

what phases of GBS are considered to be “acute”

A

latency and progression

30
Q

what “hat” do we wear during acute phase

A

preventative

31
Q

what interventions applicable during acute GBS

A

respiratory
pain control
positioning / splinting
monitor decline of muscle function
PROM/AAROM in pain-free ranges

32
Q

what setting is the acute phase of GBS treated in

A

acute care

33
Q

contraindications during acute phase GBS

A

strengthening (not even AROM)
fatiguing patient

34
Q

during all phases of GBS, what should be focused on

A

monitoring of prolonged postexercise weakness and DOMS

35
Q

what interventions are indicated during plateau phase GBS

A

all the same from acute, may begin to incorporate AROM
upright positioning
bed mobility
light functional skills

36
Q

what is contraindicated during plateau phase GBS

A

strengthening
fatiguing patient

37
Q

what interventions are indicated during recovery phase GBS

A

low rep, sub max non-resisted ex
multi joint functional activities
aerobic training with monitoring

Neuro Rehab (9 decks)

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