Guillian Barre Syndrome

Question 1

Aetiology

Answer 1

typically occurs following an infection/illness - flu, GTI, viral, following surgery

Causes an acute, idiopathic polyneuropathy as a result of a deficient autoimmune response

Question 2

Clinical Features - motor

Answer 2

ascending, bilateral weakness
symptoms progress rapidly, usually over 48 hours
LL more affected than UL
can spread to trunk and respiratory msucles
can impact cranial nerves (optic) if extensive

Question 3

Clinical Features - sensory

Answer 3

paraesthesia

hyperaesthesia

Question 4

Clinical Features - tone

Answer 4

hypotonia
reduced/absent reflexes
spreads in the same way as weakness

Question 5

Pain

Answer 5

nerve related
muscular pain
very debilitating

Question 6

Autonomic

Answer 6

fluctuating hypo/hypertension 
cardiac arrhythmias 
postural hypotension 
loss of or increased sweating 
bladder and bowel dysfunction

Question 7

Physio Management - Acute Stage

Answer 7

condition deteriorating 
chest physio 
DVT prevention 
maintain ROM and muscle length 
assess baseline muscle strength 
pain management

Question 8

Physio Management - Plateau Stage

Answer 8

condition stabilised 
chest management 
muscle strength and ROM chart 
passive and active movement all muscles 
Graded Exercise Program - no resistance and AVOID fatigue 
mobilise - SOEOB, tilt table

Question 9

Physio Management - Rehab Stage

Answer 9

regular muscle chart to record progress

Graded Exercise Program - can begin to add resistance once at G3

Question 10

Prognosis

Answer 10

depends on severity of damage, involvement of respiratory muscles and length of time in plateau phase
20% of people have residual deficits in ambulation
poor prognosis - rapid onset, ventilation, prolonged plateau phase, older age, severe weakness