Guillaine Barré Syndrome Flashcards
What would your recognise in the lumbar puncture in order to rule for GBS?
often causes an isolated rise in CSF protein
What would your recognise in the lumbar puncture in order to rule for Bacterial Meningitis?
CSF is often described as ‘cloudy and turbid’
number of white cells will typically be very high in bacterial meningitis, even more so than in viral meningitis, and will display polymorphs
Protein will tend to be high (above 1g/L), and glucose will tend to be low as the bacteria use it up (<40% of serum blood glucose)
What would your recognise in the lumbar puncture in order to rule for Viral Meningitis?
the CSF may have a normal appearance.
expect to see raised white cells with predominant lymphocytes.
protein may be normal (between 0.2-0.4 g/L) or slightly raised.
Key difference between bacterial and viral meningitis in the lumbar puncture?
-A key differentiator of viral meningitis from bacterial meningitis often comes by looking at the glucose
-in viral meningitis, glucose will often be normal or only slightly reduced (>60% of serum blood glucose).
Presents with an acute onset of bloody diarrhoea and vomiting. A stool culture is sent, the results of which are shown below:
Stool culture: Gram-negative, helical-shaped organism.
Which of the following is the most common complication following this infection?
Guillain-Barré Syndrome
- patient has Campylobacter jejuni. Guillain-Barré Syndrome
- a well-recognised complication of this infection occurring in around 1/1000 patients.
A 40-year-old female presents to the emergency department with rapidly progressing ascending weakness.
She explains that she had a stomach upset two weeks ago, but otherwise, she has no past medical history.
What condition does this present?
Guillain-Barré Syndrome
What is the best way to monitor respiratory muscle involvement in GBS patients?
Forced vital capacity (FVC)
A 34-year-old man is brought to A&E by ambulance. He reports becoming progressively weaker over the last few days, which he thought was due to a recent severe bout of diarrhoea. However, despite his diarrhoea improving, his weakness has progressed. Today he was unable to stand and so he rang an ambulance.
On examination, he has loss of sensation and motor function from the toes to the knees bilaterally.
Given the suspected diagnosis, which of the following is most appropriate to monitor regarding this patient’s prognosis?
This patient likely has Guillain-Barre syndrome, a neurological condition that typically follows an infective illness (classically enteric infection with Campylobacter jejuni).
The condition is characterised by an ascending sensorimotor paralysis that starts distally. The most concerning feature is respiratory failure due to paralysis of the respiratory muscles. Regular FVC is the most important monitoring to track this.
DR; What’s to consider when considering GBS?
Past and present Gastro/ Diarrhoea history
