Guillaine Barre

Question 1

Guillane Barre Syndrome

Answer 1

• Autoimmune disease affecting peripheral nervous system usually triggered by infectious disease process
• Acute demyelinating inflammatory polyneuropathy

Question 2

Pathophysiology

Answer 2

• Attacks Schwann cells

- 80% myelin loss, 20% axonal loss

Question 3

Diagnosis

Answer 3

• Sensory symptoms distal>proximal
• Progressive motor weakness
• Elevation of CSF protein
• Abnormal nerve conduction studies

Question 4

Acute Demylenating Inflammatory Polyradiculopathy

Answer 4

• Progressive symmetric muscle weakness, absent or depressed DTRs, often preceding illness

Question 5

Miller-Fischer Syndrome

Answer 5

• Ophthalmoplegia, ataxia, areflexia, 25% with extremity weakness

Question 6

Acute motor axonal neuropathy

Answer 6

• Selective involvement of motor nerves presents with muscle weakness and electrophysiological pattern of axonal involvement, preservation of DTRs
• Sensory not affected
• More prevalent in summer preceded by C Jeuni Infection

Question 7

Acute motor sensory axonal neuropathy

Answer 7

• Sensory and motor marked axonal degeneration

- Delayed or incomplete recovery

Question 8

Bickerstaff encephalitis

Answer 8

• Ophthalmoplegia and ataxia with encephalopathy, hyperreflexia

Question 9

Pharyngeal-cervical-brachial

Answer 9

Acute arm weakness and swallowing dysfunction

- Can have facial weakness, leg strength, and reflexes preserved

Question 10

Autonomic impairments

Answer 10

• Low CO
• Cardiac dysrhythmias
• BP fluctuations
• Ileus
• Urinary retention

Question 11

Differential Diagnoses

Answer 11

1. Polyneuropathies
2. SC Injury
3. Neuromuscular junction disorders (myasthenia gravis)
4. Muscle disorders (polymyositis)

Question 12

Clinical Course

Answer 12

1. Acute Phase - rapid progression of symptoms; symptoms peak at nadir 2-3 weeks
2. Plateau Phase - stability of symptoms
3. Recovery phase - improvement of symptoms; generally 2-4 weeks after plateau

Question 13

PT Exam

Answer 13

1. History
2. ROM
3. Motor function/control
4. Sensory
5. Reflex
6. Pain
7. Cardiovascular and respiratory
8. Skin integrity
9. Functional mobility & balance

Question 14

Acute Phase Interventions

Answer 14

1. Maintain ROM
2. Minimize pain
3. Maintain skin integrity
4. Pulmonary function and airway clearance
5. Functional training
6. Balance training
7. Adaptive Equipment

Question 15

Exercise Prescriptions for GBS patients

Answer 15

1. Evaluate for overwork symptoms
2. Sub-max strength training as recovery begins
3. Sub-max aerobic training (60-80% HR max)
4. Functional activity practice