Guillian Barre Syndrome

Question 1

What is Guillian Barre Syndrome

Answer 1

Acute paralytic polyneuropathy that affects the peripheral nervous system
Causes acute, symmetrical, ascending weakness and can also cause sensory symptoms

Question 2

What triggers Guillian Barre virus

Answer 2

Campylobacter jejuni
Cytomegalovirus
Epstein Barr virus

Question 3

Ascending paralysis

Answer 3

Paralysis that gradually moves from the lower part of the body towards the upper part

Question 4

Pathophysiology of Guillian Barre Syndrome

Answer 4

Molecular mimicry

B cells make antibodies against pathogenic antigens which are similar to those of nerve cells therefore also damaging nerve cells

May target proteins on the myelin sheath

Question 5

Presentation of Guillian Barre Syndrome

Answer 5

• Symmetrical ascending weakness
• Hyporeflexia
• Peripheral loss of sensation or neuropathic pain
• may progress to cranial nerves and cause facial weakness

Question 6

Clinical course of Guillian Barre Syndrome

Answer 6

Symptoms usually present within 4 weeks of an infection
Usually start in feet and progress upward
Symptoms peak within 2 - 4 weeks
Recovery can take months to years

Question 7

How to diagnose Guillian Barre Syndrome

Answer 7

Brighton Criteria or clinically

Question 8

Investigations for Guillian Barre Syndrome

Answer 8

Nerve conduction studies

Lumbar puncture for CSF - raised protein with normal cell count and glucose

Question 9

Management of Guillian Barre Syndrome

Answer 9

IV immunoglobulins
Plasma exchange
Supportive care
VTE prophylaxis

If respiratory failure - ventilation and intubation

Question 10

Prognosis of Guillian Barre Syndrome

Answer 10

80% recover
15% some neurological instability
5% death