07/03/2021 [RBD, GBS, LBMP, hip joint, asthma, ] Flashcards
(95 cards)
What is GBS?
Rapid-onset muscle weakness caused by the immune system damaging the peripheral NS
Sx of GBS
Muscle weakness beginning in the feet and hands, usually ascending upwards
The serious Cx and how common is it?
Weakness breathing muscles with about 15% developing weaknesses that require mechanical ventilation
Common trigger
Infection, or less commonly, by surgery. Rarely, by vaccination.
Dx of GBS
Usually Sx and Sx though exclusion by NCS and examination of CSF
Tx for GBS
Prompt Tx with IVIG or plasmapheresis
Recovery for GBS
Weeks to years
How common is permanent weakness?
1/3rd
How common is Cn involvement?
In about half of cases, leading to muscles of the face/eyes paralysis, swallowing difficulties
How long is the plateau phase commonly?
2d-6m potentially, but most commonly a week then gets better
How common is pain in GBS?
About half of cases, incl. back pain, painful tingling, muscle pain, pain head/neck relating to irritation lining of the brain
What do many people have prior to a GBS infx?
Sx and Sx of an infection 3-6w prior to onset neuro Sx; consist of URTI or diarrhoea
Which group can be mistaken often?
Children, as often initially mistaken [for up to 2w] for other causes of pains and difficulties walking, such as infx, or bone/joint problems.
Neuro examination in GBS?
On neurological examination, characteristic features are the reduced strength of muscles and reduced or absent tendon reflexes (hypo- or areflexia, respectively).However, a small proportion have normal reflexes in affected limbs before developing areflexia, and some may have exaggerated reflexes
What is the Miller Fisher variant of GBS?
In the Miller Fisher variant of Guillain–Barré syndrome (see below), a triad of weakness of the eye muscles, abnormalities in coordination, as well as absent reflexes can be found.
Resp failure how common?
25%
Other system affected in GBS?
2/3rds have HR and BP problems as autonomic NS is effected.
20% may experience severe BP fluctuations and irregularities of the hear.t
Epidemiology of GBS?
Children/young adults less likely, men more likely [1.78x].
Causes of GBS?
2/3rd have infection. Commonoyl gastroenteritis, or URTI.
30% caused by campylobacter jejuni bacteria which cause diarrhoea, 10% by cytomegalovrisu.
Death rate GBS
5%, even with good care.
Hip joint articulation
Head of femur, acetabulum
How is the acetabalum deepened?
By teh acetabular labrum
Ligaments intracapsular
Ligament of head of femur
What does the ligament head of femur encase?
Obturator artery [minor blood supply hip]
