Guillian Barre syndrome Flashcards
What is GBS
Immune process cellular mimicry attacking myelin sheathe (antibodies to ganglosides) of multiple nerves
Classical features GBS
GI/resp infection 2-3 weeks before
Paraesthesia lower limbs, no sensory loss
Symmetrical LMN ascending weakness lower limbs > upper
What is the most common Acute inflammatory demyelinating polyneuropathy
GBS
Most common bacteria causing GBS
Campylobacter jejuni
Presentation GBS
- Mild paraesthesia of lower limbs
- Progressive weakness starts in lower limbs progressing to upper limbs
- Flaccid paresis with areflexia
- Often no sensory deficit
- Back or leg pain - nerve root inflammation
-Autonomic symptoms
Autonomic symptoms in GBS
Early - sus spinal cord lesion/cauda equina
Bladder and bowel v late disease
Sudden changes in BP/HR - rare
When is the peak of GBS?
2 weeks
Phases of GBS
Worsen over 2 weeks then plateau. Dramatic recovery at least 28 dyas after onset and plateau phase
Prognosis GBS
Majority -> normal function
Some have residual deficit eg fatigue, weak
What is so dangerous about GBS?
Resp muscle involvement
-> resp failure
Why is FVC vital analysis in GBS?
Neuromuscular resp failure can cause death / ICU admission
Most useful prognostic indicator for ventilation (reducing O2 occurs much later)
Variants of GBS
Sensory symptoms only
Axonal injury
Miller-Fischer syndrome
What can you test for in GBS on blood tests
Raised CK, abnormal LFTs
Inflam markers + biochem
Anti-gangloside antibodies (specific GBS variants)
Investigations GBS
Bloods - baseline, CK, LFTs, inflam markers, anti-gnagloside abs
Lumbar punture
Nerve conduction studies, EMG
What find on LP in GBS?
Albuminocytologic dissociation
Elevated protein but little to no cells
