guillian-barré syndrome (GBS) Flashcards
1
Q
what is GBS
A
- acute paralytic polyneuropathy
- quick, asymmetrical onset
- ascending weakness
2
Q
which types of nerves does GBS affect, what does it cause
A
- peripheral nerves
- sensory nerves, causes sensory neuropathy
3
Q
GBS cause
A
infection
4
Q
GBS pathophysiology
A
- molecular mimicry
- B-cells make antibodies against infection
- antibodies attack proteins on nerve cells (axons, myelin sheath) too
- damage to nerve cell –> neuropathy
5
Q
GBS key presentation
A
symmetrical ascending weakness
6
Q
GBS symptoms
A
- reduced reflexes (peripheral neuropathy)
- peripheral loss of sensation
- neuropathic pain
- (if reaches CNs) facial nerve weakness
7
Q
GBS timeframe (onset after infection, peak infection, recovery)
A
- within 4 weeks
- peaks at 2-4 weeks
- months to years recovery
8
Q
GBS diagnosis
A
- clinical diagnoses (no 1 test)
- Brighton criteria
- nerve conduction studies (reduced signal)
- lumber puncture (increased CSF protein)
9
Q
GBS treatments
A
- IVIG (IV immunoglobulins)
- plasma exchange –> remove antibodies
- supportive care
- venusthromboembolism (VTE) prophylaxis –> prevent blood clots
10
Q
leading cause of death in GBS
A
pulmonary embolism
11
Q
GBS prognosis
A
- 80% fully recover
- 15% some neurological disability (weakness, neuropathic pain)
- 5% die
12
Q
GBS can ascend to involve ?
A
- phrenic nerves
- affect diaphragm and intercostal nerve muscles
13
Q
diagnostic clue for GBS
A
- elevated CSF proteins in LP
- few inflammatory cells in CSF
14
Q
things to cause diagnostic doubt
A
- asymmetrical presentation
- sensory level impairment
- bladder or bowel dysfunction (spinal cord issue, not nerves)
- high inflammatory cells in CSF in LP
15
Q
nerve conduction results
A
- nerves conduct slowly
- distal latency prolonged
- indicate demyelinating or axonal neuropathy
16
Q
treatment goal
A
dampen immune response
