Guillain Barre Syndrome

Question 1

What is it?

Answer 1

A rare disorder in which your body’s immune system attacks your nerves.

Question 2

Causes:

• Some pathogens that cause an URTI may also cause this. Name a few?
• Some pathogens that cause GE may also cause this. Name one?

Answer 2

CMV
EBC
Mycoplasma

Campylobacter jejuni

Question 3

Time course:

Acute/chronic?

How long is it at its peak?

What is CIDP?

Answer 3

Acute

2-4 wks then they recover

Chronic Inflammatory Demyelinating Polyneuropathy - basically when the GBS symptoms fail to plateau and begin improvement within 8 wks

Question 4

S+S:

How many wks after infection does it present?

Ascending motor and sensory problems:

• Sensory issue - 1
• Motor issue - 1
• What is affected first?
• Then what is affected? - 3
• Is it usually sym/assym?

Answer 4

Distal paraesthesia
Proximal weakness

Limbs (usually legs)
Trunk, respiratory muscles, and cranial nerves (especially CN 7)

Usually symmetrical

Question 5

S+S:

Other features:

• Reflexes
• Where do you get pain? - 2
• What autonomic symptoms do you get?

Answer 5

Hyporeflexia
Back and limb

Anhydrosis
Arrhythmias - tachycardia, HTN

Question 6

DDx of acute neurogenic ventilatory failure

Answer 6

GBS
MG
MND

Question 7

Investigations:

Bloods:

• Why do you do U&E?
• How can a GE infection be screened for?

Special tests:

• What can be used to show slowed conduction?
• Why is an LP done?
• What can be used to look for respiratory compromise?

Imaging:

• Why is an MRI done?
• What may an ECG show?

Answer 7

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by excessive unsuppressible release of antidiuretic hormone (ADH) either from the posterior pituitary gland, or an abnormal non-pituitary source

Stool culture 
-------
Nerve conduction studies 
Raised protein in CSF
Spirometry 
--------
To rule out other causes (e.g. disc problems) 
Arrhythmias and heart block

Question 8

Management:

What needs to be done first?

When is IVIg or plasma exchange?

Answer 8

Supportive Rx, including HR and BP control

If severe