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Flashcards in guillian barre syndrome Deck (25):
1

what is guillian barre syndrome?

an acute demyelinating polyneuropathy

2

how does the classic guillian barre patient present?

viral infection or diarrhoe prodrome (75%)

few weeks later becomes weak over days

first legs than arms

mild sensory changes
can be facial, bulbar and/or respiratory weakness

signs of lower motor neuron dysfunction

3

what does lower motor neuron dysfunction indicate in guillian barre?

acute neuropathy

4

what does the LP for guillian barre show?

high protein

5

what does the NCS for guillian barre show?

demyelination

6

what are the LMN lower motor neurone problem sings

decreased tone

distally weak (sometimes pyramidal)

absent reflexes

absent clonus

plantar responses flexor or absent

7

what is chronic inflammatory demyelinating polyneuropathy?

chronic demyelinating neruopathy similar to guillain barre

8

how does CIDP, chronic inflammatory demyelinating polyneuropathy typically present?

similar to GBS but slower
with relapses

not usually prodrome (ie diarrhea) OR resp failure

LMN signs

LP high protein, NCS demyelination

ICP headaches

facial weakness and opthalmoparesis

9

how is CIDP treatable?

immunosurpressants

good evidence for steroids (lancet 2006)

steroid sparing agents may be useful

IViG

10

in what ways is CIDP different to guillian barre?

doesnt usually occur with prodrome

is chronic rather than acute

autonomic dysfunction

GBS does not respond to steroids

11

what point is nadir in CIDP and GBS?

guillian barre 8 weeks

12

what tree conditions could be used to describe the continuum between GBS and CIDP

acute inflammatory demyelinating polyneuropathy (AIDP)

subacute inflammatory demyelinating polyneuropathy (SIDP)

chronic inflammatory demyelinating polyneuropathy (CIDP)

13

how is guillian barre treatable?

with IViG

supportive care

NG feeding

steroids ineffective

14

what is the incidence of guillian barre?

2 per 100,000

15

specifically, how does GBS present?

ascending symmetrical weakness hours to days

pain 2/3

LMN signs +/- mild sensory signs

facial weakness

respiratory weakness
bulbar involvement
CVS instability
sphincter signs

16

what are the GBS mimics?

acute spinal cord lesion

crtical illness polyneuropathy

CIDP

HIV, lyme (rare)

17

what are the GBS chameleons?

AMAN
AMSAN
miller-fisher syndrome

18

what tests should be performed for GBS and CIDP?

lumbar puncture

nerve conduction study (demyelination)

MRI (Exclude cord lesions)

infective serology

19

in rare cases what antibody can be testes for in guillian barre?

ganglioside antibodies

20

what happens to the F wave in GBS?

delayed

21

what is prognosis for GBS?

most patients fully recover

residual disability

22

what age does CIDP mostly affect?

any age but mostly 40-60

23

what is the incidence of CIDP?

1:200,000

24

what two types of CIDP are they?

relapsing and progressive

25

what is the pathogenesis of GBS?

T cells mistake myelin as foreign

linterleukin2 involved

cytokines attact macrophages which attack myelin