Guillain-barre syndrome

Question 1

features of guillain barre syndrome ?

Answer 1

ascending symmetrical muscle weakness involving all 4 limbs

absent/reduced reflexes

back/leg pain may precede onset of the illness

mild sensory signs/symptoms (e.g. paraesthesia)

others;

• Hx gastroenteritis
• CN palsy e.g. diplopia
• respiratory muscle weakness - type 2 Respiratory failure
• autonomic involvement (e.g. urinary retention, diarrhoea, arrhythmia)

Question 2

how is guillain barre syndrome managed?

Answer 2

IV immunoglobulin

if refractory disease - plasmapheresis

Question 3

what is the pathophysiology of Guillain barre ?

Answer 3

immune mediated demyelination the peripheral nervous system

cross reaction of antibodies with glycosides

anti-GM1 (anti-glycoside) antibodies in 25% patients

Question 4

what antibody is associated with guillain barre syndrome?

Answer 4

anti-glycoside antibody (anti-GM1)

Question 5

what investigations would you carry out if you suspected guillain barre?

Answer 5

LP

anti-glycoside antibodies

Question 6

what would a lumbar puncture show if the patient had guillain barre ?

Answer 6

increased protein
normal WCC
normal glucose
albuminocytological dissociation