Guillian-Barre Syndrome

Question 1

Etiology

Answer 1

Inflammatory disease that causes demyelination of axons in PNS. Two-thirds develop it after infection

Question 2

Signs and Symptoms

Answer 2

Three Phases:
Onset - acute inflammatory, acute weakness in at least two extremities that advances to a max in 2-4 weeks occasionally requiring mechanical ventilation
Plateau - symptoms are at their most disabling with little or no change over a few days or weeks
Recovery - remyelination and axonal regeneration occur over a period as long as 2 years. recovery tends to start at the head and neck and travel distally with significant or complete return of function with residual fatigue

Symptoms progress rapidly in a symmetrical pattern of flaccid paralysis from feet to head with pain, fatigue, edema, absence of deep tendon reflexes, mild glove-stocking sensory loss, potential autonomic nervous system involvement.

Question 3

Diagnosis

Answer 3

neurological exam, nerve conduction velocity test, CSF analysis

Question 4

Prognosis

Answer 4

no cure, recovery rate varies but 50% fully recover and 15% have permanent dysfunction.
fatigue and mild cognitive symptoms being residual

Question 5

Team Management

Answer 5

medication to reduce severity and speed recovery
Respiratory Therapist maybe
SLP maybe
PT

Question 6

OT Evaluation

Answer 6

Referrals occur when GBS is moderate to severe. In plateau phase, screening and evlauation occur in ICU and covers communication, control of physical environment, comfort positioning, anxiety management
Recovery phase focuses on mobility, self care, ADLs, communication, leisure, workplace/community reintegration

Question 7

OT Intervention

Answer 7

Plateau Phase:
- use of communication tools
- environmental modifications
- hands-free telephone
- positioning schedule
- anxiety reduction techniques
Recovery Phase
- dynamic splints
- safe mobility/transfers
- self-care
- communication
- energy conservation/fatigue management
- Fine motor
- home/enviornment modification