Unit 8: GBS Flashcards
What is GBS?
-aka Acute Inflammatory Demyelinating Polyneuropathy
-Autoimmune disorder
-Results in acute neuromuscular failure
-The body’s immune system attacks the myelin sheath covering the nerve, resulting in a slower signal transmission through the nerve
Etiology of GBS
-Exact etiology is unknown
-Distribution is worldwide
-1.3 – 2 per 100,000
-1.5x more likely in men
-Ages: 20–24, and 70–74
-No hereditary susceptibility or vaccinations cause GBS
-Enteritis precedes GBS in 41% of cases
-Some respiratory infections, HIV & AIDS
3 Main Types of GBS
-Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)
-Miller Fisher Syndrome (MFS)
-Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-Sensory Axonal Neuropathy (AMSAN)
Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) (Types of GBS)
-The most common form in the U.S.
-Most common sign= Muscle weakness that starts in the lower part of your body and spreads upward.
Miller Fisher Syndrome (MFS) (Types of GBS)
-In which paralysis starts in the eyes
-Also associated with
unsteady gait.
-Occurs in about 5% of people with in the U.S. but is
more common in Asia.
Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-Sensory Axonal Neuropathy (AMSAN) (Types of GBS)
-Less common in the U.S.
-But AMAN and AMSAN are more frequent in China, Japan and Mexico.
Characteristics of GBS Include
-Weakness and Tingling in extremities is usually first symptom
-Cognition remains intact
-Quickly progressing, symmetrical ascending
paralysis starting with the feet
-Pain in the legs
-Absence of deep tendon reflexes
-HTN
-Tachycardia
-Fatigue
-Urinary dysfunction
-Respiratory muscle paralysis
-Possible facial palsy
3 phases of GBS
-Phase 1: Acute Inflammatory Phase: 95% of people manifests as weakness in at least 2 limbs that progresses and reaches maximum within 2 – 4 weeks with increasing symptoms (20–30% require mechanical ventilation)
-Phase 2: Plateau *NO significant changes
-Phase 3: Progressive Revery
Prognosis/ Presentation
-Full recovery can occur within as little as a few weeks to a few years
- 1–10% of people die
-50% of patients have full recovery
-40% require rehabilitation services
-35% experience some residual weakness
-15% experience some residual weakness that may not resolve
-Fatigue is the most common residual problem for 93% of patients
Common Functional Impairments in GBS
-Decreased ADL I
-Decreased IADL I
-Decreased Mobility
-Skin, Falls, possible DVT
-Decreased balance
-Decreased muscle strength
-Fatigue
-Inability to fulfill roles
-Sleep
Common Functional Impairments in GBS
-Decreased ADL I
-Decreased IADL I
-Decreased Mobility
-Skin, Falls, possible DVT
-Decreased balance
-Decreased muscle strength
-Fatigue
-Inability to fulfill roles
-Sleep
Possible Assessments for GBS
-Pain scale
-Beck Depression Scale
-FIM
-COPM
-7 point GBS disability scale
-Semmes Weinstein
-ROM/MMT
-Dynamometer
-Grip, Pincher, 3 point, Lateral pinch
Possible Assessments for GBS
-Pain scale
-Beck Depression Scale
-FIM
-COPM
-7 point GBS disability scale
-Semmes Weinstein
-ROM/MMT
-Dynamometer
-Grip, Pincher, 3 point, Lateral pinch
Acute phase: Possible Treatments
-Communication tools such as a picture board, signs or voice activated devices (if appropriate)
-Adapted: calls lights, T.V. controller, & lights (PRN)
-Hands free telephone
-Strategies to reduce anxiety
-Body positioning
Recovery Phase: Possible Treatments
-Provide/perform activities and dynamic splints to maintain ROM
-Patient & caregiver education
-Sensory stimulation or desensitization program
(PRN)
-Transfer training
-Modified self-care techniques and adapting activities
-Re-arranging routines/schedule
-Energy conservation techniques/fatigue management
-Employment modification
-Strengthening gross and fine motor, enhancing
sensation
-Complete a home assessment/modifications assessment
