Guillian-Barre Syndrome

Question 1

RF

Answer 1

Recent infection campylobacter, CMV, EBV or HIV.

Gastro or resp infection

Question 2

Presenting

Answer 2

Weakness, hyporeflexia, altered sensation, pain.

Starts in lower extremities first.

Autonomic symptoms: Reduced sweating, reduced heat tolerance, paralytic ileus and urinary hesitancy. Severe autonomic dysfunction may occur.

Question 3

Investigations

Answer 3

Nerve conduction studies.

CSF, elevation in proteins in 1 week.

Spirometry to see if diaphragm effected.

Question 4

Management

Answer 4

Urgent referral to neurology, if organ failure then ITU.

Plasma exchange therapy, plasmaphoresis.

Intravenous immunoglobulin.

Laxatives if paralytic ileus.

DVT prophylaxis

ECG monitoring and spirometry.