Flashcards in Guillain-Barré Syndrome Deck (18):
What is Guillain-Barré Syndrome?
idiopathic acute/subacute inflammatory demyelinating polyneuropathy
MC microorganism a/w Guillain-Barré Syndrome?
EBV, cytomegalovirus, HIV, Zika
Guillain-Barré Syndrome is the MC cause of ____ ?
acute atraumatic generalized paralysis in all age groups
Explain the pathophys of Guillain-Barré Syndrome
-antecedent infection invokes immune response
-antibodies attach to peripheral nerve cells (molecular mimicry)
-macrophages attack peripheral nerves
(select antibodies attack axons/myelin)
What is the MC variant of GBS? what is it?
Acute inflammatory demyelinating polyneuropathy (AIDP)
-progressive symmetric weakness accompanied by absent or depressed DTRs
-Paresthesias in the hands and feet
Characteristics of Acute Motor Axonal Neuropathy
-Japan and China
-DTRs may be preserved
-no sensory involvement
Characteristics of Acute motor and sensory axonal neuropathy
-AMAN + sensory nerve involvement
-Higher severity than AMAN
Characteristics of Miller Fisher syndrome
-Ophthalmoplegia w/ ataxia and areflexia
-only 25% develop extremity weakness
What happens to the CSF in GBS?
-macrophages damage the peripheral nerve dural attachment
-breakdown of the peripheral nerve CSF
-allows passage of proteins into CSF
What are sx of GBS?
-Progressive SYMMETRIC ascending muscle weakness weakness and diminished DTRs
-Gait disturbance- ataxic component out of proportion to the muscle weakness
-cranial nerve may be involved
What part of the body is initially affected in GBS?
progressively involves the trunk
then upper extremities
What is needed for dx of GBS?
-elevated protein w/ nl WBC (albuminocytologic dissociation)
When performing a LP for GBS, what do you need to consider?
-usually nl in 1st 2-3 days
-90% will be abnormal at 1 week
-peak is 3-6 weeks
What do you need to classify GBS?
You would defer this to electrophysiologist
Nerve conduction studies (NCS)
needle electromyography (EMG)
How do you treat GBS?
-close monitoring of respiratory and cardiovascular fxn
Plasmapheresis (to remove antibodies)
Do you give corticosteroids in GBS?
NAHHHH not beneficial
How long does recovery take from GBS?
spontaneous recovery 3-4 weeks from sx onset