L5: Acute Flaccid Paralysis Flashcards
Introduction to motor unit
Def of
- Neuronopathy
- Neuropathy
- Myopathy
Def of Acute Flaccid Paralysis
Etiology of Acute Flaccid Paralysis
Etiology of Acute Flaccid Paralysis
- Spinal Cord
- Acute transverse myelitis
- Trauma
Etiology of Acute Flaccid Paralysis
- AHCs
- Poliovirus & polio vaccination
- Other neurotropic viruses e.g. CMV, EBV, HSV
Etiology of Acute Flaccid Paralysis
- Peripheral Nerves
- Guillain Barrรฉ syndrome
- Critical illness neuropathy
- Toxic neuropathy (arsenic, lead)
- Diphtheritic neuropathy
Etiology of Acute Flaccid Paralysis
- NMJ
- Myasthenia gravis
- Botulism
- Organophosphate poisoning
- Snakebite
Etiology of Acute Flaccid Paralysis
- Muscles
- Inflammatory myopathies
- Critical illness myopathy
Etiology of Acute Flaccid Paralysis
- Muscle Membrane
- Familial periodic paralysis
- 2ry hypokalemic paralysis
CP of Acute Flaccid Paralysis
CP of Acute Flaccid Paralysis
- Weakness appears first in โฆ..
Lower Limb
CP of Acute Flaccid Paralysis
- Initial Complaint
Abnormal gait with proximal or distal leg weakness
CP of Acute Flaccid Paralysis
- With Proximal Weakness
CP of Acute Flaccid Paralysis
- With Distal Weakness
Physical Examination in Acute Flaccid Paralysis
Dx of Acute Flaccid Paralysis
INVx in Acute Flaccid Paralysis
INVx in Acute Flaccid Paralysis
- Spinal Cord Lesions
INVx in Acute Flaccid Paralysis
- Peripheral Nerve Lesions
INVx in Acute Flaccid Paralysis
- NMJ Lesions
Repetitive nerve stimulation (RNS)
INVx in Acute Flaccid Paralysis
- Muscle Lesions
Manamgment of Acute Flaccid Paralysis
Manamgment of Acute Flaccid Paralysis
- ABC
- Ensure airway protected and adequate ventilation
- Check BP & HR
Manamgment of Acute Flaccid Paralysis
- Specific TTT
Introduction to Guillian Barrรฉ Syndrome
Epidemeology of Guillian Barrรฉ Syndrome
Etiology of Guillian Barrรฉ Syndrome
Etiology of Guillian Barrรฉ Syndrome
- Causative agents
It occurs 2 - 4 weeks after a benign febrile illness:
- 2/3 of cases follow a respiratory or gastrointestinal infection
- Campylobacter infection 20 - 30%
- Others e.g. CMV, EBV, HSV
GBS has been reported to follow:
- Vaccinations
- Epidural anesthesia
- Thrombolytic Agents
Pathogenesis of Guillian Barrรฉ Syndrome
Subtypes of Guillian Barrรฉ Syndrome
CP of Guillian Barrรฉ Syndrome
CP of Guillian Barrรฉ Syndrome
- Motor
CP of Guillian Barrรฉ Syndrome
- Sensory
CP of Guillian Barrรฉ Syndrome
- Autonomic
CP of Guillian Barrรฉ Syndrome
- CNs
INVx for Guillian Barrรฉ Syndrome
INVx for Guillian Barrรฉ Syndrome
- CSF Analysis
INVx for Guillian Barrรฉ Syndrome
- Electrophysiological Studies
Management of Guillian Barrรฉ Syndrome
Management of Guillian Barrรฉ Syndrome
- Indication of PICU Admission
Management of Guillian Barrรฉ Syndrome
- Specific TTT
Management of Guillian Barrรฉ Syndrome
- IVIG
Management of Guillian Barrรฉ Syndrome
- Advantages of IVIG
IVIG is the preferred immunomodulatory treatment as it is
- easier to give
- few side effects
- the treatment can be implemented more quickly
- good outcome as plasmapheresis