Guillian-barre syndrome

Question 1

What system does Guillain barre syndrome affect?

Answer 1

peripheral nervous system

Question 2

What affect does Guillain barre syndrome have

Answer 2

it causes acute symmetrical ascending weakness and can also cause sensory symptoms

Question 3

What triggers Guillain barre syndrome?

Answer 3

triggered by an infection:
- campylobacter jejuni
- cytomegalovirus
- Epstein-barre virus

Question 4

By what process does Guillain barre syndrome occur

Answer 4

molecular mimicry

Question 5

What is the pathophysiology of Guillain barre syndrome

Answer 5

the B cells create antibodies against the antigens on the triggering pathogen and these antibodies match the proteins on the peripheral neurones

Question 6

What is the time course of Guillain barre syndrome

Answer 6

starts within 4 weeks of the triggering infection
peaks in the first 2-4 weeks and recovery period can last months to years

Question 7

What are the symptoms of Guillain barre syndrome

Answer 7

• begin in the feet and move up
• symmetrical ascending weakness
• reduced reflexes
• peripheral loss of sensation or neuropathic pain
• may progress to cranial nerves and cause facial weakness

Question 8

What can autonomic dysfunction lead to?

Answer 8

urinary retention, ileum or heart arrhythmias

Question 9

How is a diagnosis of Guillain barre syndrome made

Answer 9

made clinically using Brighton criteria
- nerve conduction studies showing reduced signal through nerves
- lumbar puncture for CSF showing raised protein with normal cell count and glucose (albuminocytological dissociation)

Question 10

What is the management of Guillain barre syndrome

Answer 10

• supportive care
• monitor vital capacity
• VTE prophylaxis (PE is leading cause of death)
• IV immunoglobulins
• plasmapheresis as alternative to IVIG

Question 11

What are the severe complications of Guillain barre syndrome

Answer 11

respiratory or cardiovascular complications
PE