Guillain-Barre Syndrome

Question 1

Where is the autoimmunity targeting in GB syndrome?

Answer 1

The PNS

Question 2

Does GB usually go away?

Answer 2

Yes within around 6-12 months. That is why it is not tradition autoimmunity because traditional autoimmunity is lifelong

Question 3

What is the etiology of GB syndrome?

Answer 3

Idiopathic - truly autoimmune but not of the traditional type

Question 4

What GB preceded by about 1-4 weeks before autoimmunity starts?

Answer 4

Preceded by URT (viral infection usually EBV) or GI (bacterial infection usually compylobacter jejuni)

Question 5

What is the patho of GB syndrome?

Answer 5

Abs and T cells target myelin sheaths in PNS -> damage of Schwann cells -> inflammation and damage -> loss of conduction

Question 6

What are the manifestation of GB syndrome?

Answer 6

Signs of infection from URT or GI (if still present when autoimmunity starts)
Parasthesias (numbness and tingling) that turns into muscle weakness and then paralysis

Question 7

What is unique about the progression of manifestations of GB syndrome?

Answer 7

The parasthesias start in the feet and then move in ascending order up the body. When the manifestations begin to go away they go away in descending order.

Question 8

When parasthesias from GB syndrome pass either the hips or shoulders what is experienced?

Answer 8

Deep muscle pain

Question 9

What is the main cause of death from GB syndrome?

Answer 9

Respiratory failure

Question 10

How is GB syndrome diagnosed?(4)

Answer 10

Hx
Px (neuro & musculoskeletal exam to determine whether it is a neural, muscular or neuromuscular issue)
Weak tendon reflexes
Decreased nerve conduction
CSF analysis - slightly elevated proteins as innervation for PNS is at spinal cord

Question 11

What is the treatment for GB syndrome?(4)

Answer 11

Preserve life
Plasmapheresis
IV IgG (immunoglobulins)
Pain meds

Question 12

What is GB syndrome?

Answer 12

Untraditional autoimmunity that results in general paralysis