Neuro Flashcards
GBS
GBS is a postinfectious ___
Polyneuropathy
In GBS; Involves only motor nerves T/F
False; sensory and sometimes autonomic nerves can be affected
In GBS; the onset usually starts __ days after a GI or respiratory infection
Aprox 10 days
In GBS; Cite 3 main sources of GI infection
Undercooked poultry; unpasteurized milk; contaminated water
In GBS; West Nile virus can mimic GBS but more often causes ___
Motor neuron disease similar to poliomyelitis
In GBS; Cite 3 vaccines related to GBS
Rabies; influenza; Menigo C
In GBS; Initial symptoms include… 3
Numbness and paresthesia; followed by weakness
In GBS; Radicular back pain and myalgia are common in the initial stage T/F
True; children can be very irritable
In GBS; Weakness starts from __ to __
Lower limbs; uppper limbs and finally bulbar muscles
In GBS; weakness is usually (Asymmetric/Symmetric)
Symmetric
In GBS Weakness progresses over ___ to ___; reaching a nadir at ___
days to weeks; 4wks
In GBS; percentage of children that lose the ability to walk:
60%; small proportion progress to flaccid tetraplegia
In GBS; What percentage pressents bulbar involvement?
50%; can result in respiratory insufficiency
In GBS; Signs of impending respiratoy failure (3)
Dysphagia and facial weakness; hoarse voice
In GBS; Autonomic involvement can present as… (4)
BP labylity; HR lability; post hypotension; asystole
In GBS; Tendon reflexes are lost latter in the clinical presentation
False; usually occurs early; may be only hyporeflexia; 10% retain reflexes
In GBS; CIDP symptoms develop over __; recur intermittently and can progress over…
4-6wk; months to years
In GBS; CIDP weakness is both ___ and ___ and ___ severe
Chronic inflammatory demyelinating polyradiculopathy
distal; proximal; variably
In GBS; CIDP hypo or areflexia is
Chronic inflammatory demyelinating polyradiculoneuropathy
Almost universal
In GBS; Classic weakness includes…
Tetraparesis with or without motor involvement
In GBS; Paraparetic weakness includes…
Lower limbs
In GBS; Pharyngeal-cervical-brachial weakness includes…
Bulbar; neck; upper limbs
In GBS; Bifacial weakness with paresthesias includes…
facial involvement
In GBS; MFS includes…
Miller-fisher syndrome
External ophthalmoplegia; ataxia
In GBS; Bickerstaff’s brainstem encephalitis includes…
External ophthalmoplegia; ataxia; hyppersomnolence
In GBS; DDx should include (5)
Spinal cord lesions; peripheral neuropathies; Junction disorders; Myophaties; Others
In GBS; CSF PTN is elevated/reduced
Elevated; usually more than 2x upper limit
In GBS; CSF glicose and celullarity are…
normal and no pleocytosis; there should be less than 10 wbc
In GBS; Cytoalbuminologic dissociation can take up to ___ to show up
A week from the onset of symptoms
In GBS; Typical findings of MRI include…
Thickening of the cauda equina and intrathecal nerve roots with “gadolinium” enhancement
In GBS; Electromyography shows…
Motor and sensory nerve cond velocity reduction; reflecting patchy nature of nerve involvement
In GBS; CPK levels are…
Mildly elevated or normal
In GBS; Serum antiganglioside antibodies against ___ and ___ are sometimes elevated
GM1; GD1
In GBS; Sural nerve biopsy shows… (3)
Segmental demyelination; focal inflammation; “Wallerian degeneration”
In GBS; Respiratory effort must be monitored by…
Bedside testing or spirometry
In GBS; Mild cases may be treated expectantly T/F
True; most present spontaneous remission
In GBS; IV immunoglobulin should be used in…
Severe or rapidly progressive muscle weakness; 0.4g/kg/day for 5 days or 1g/kg/day for 2
In GBS; Alternatives to ImunoG (2)
Plasmapheresis and/or immunosuppressive drugs
In GBS; Steroids can be used as an alternative to ImunoG T/F
False; not effective for weakness; may help with pain
In GBS; Supportive care includes (6)
Respiratory sup; Nutricional sup; Prev bed sores; prev trombosis; Tx secondary inf; pain management
In GBS; Neuropathic pain can be treated with (2)
Narcotics; “Gabapentin”
In GBS; CIDP can be treated with… (3)
Chronic inflammatory demyelinating polyradiculopathy
Steroids; IVIG; refractory cases may need immunossuppressants
In GBS; the course is ___phasic
Mono
In GBS; recovery begins within…
2-3wks; can take months
In GBS; IVIG ___ recovery
Hastens; “doesn’t” alter long-term outcome
In GBS; Severity is an indicator of long and possibly incomplete recovery T/F
TRUE
IOT, progression rate of symptoms
In GBS; (Demyelinating/axonal) forms predict faster recover than(Demyelinating/axonal) forms
Demyelinating;axonal
In GBS; Tendon reflexes are recovered early T/F
False; usually last to recover
In GBS; recovery follows a ___ pattern
Head to lower limbs; opposite of presentation
In GBS; Cite 2 mains symptoms required for DX
Progressive weakness in legs and arms; Areflexia
In GBS; Cite 3 common complications
Venous thrombosis; pressure ulcer; Pulmonary inf
In GBS; EGRIS score meassures…
Risk of respiratory failure
In GBS; IVIG is indicated by using wich score?
GBS disability score; >/=3
