Gullain Barre Flashcards
Define guillain barre
A group of acute immune mediated polyneuropathies that generate an acquired weakness often following infection that may be complicated by respiratory failure or autonomic dysfunction
Define polyneuropathy
Polyneuropathy is damage or disease affecting peripheral nerves (peripheral neuropathy) in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain
Define autonomic dysfunction
Autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly
Why can gullain barre be difficult to diagnose?
Its very rare
Sometimes patients have variant symptoms
Sometimes paralysis moves in opposite direction it traditionally does
What is the leading subtype of gullain barre?
Acute inflammatory demyelinating polyneuropathy (AIDP)
What is meant by the term molecular mimicry in regards to gullain barre?
Antigens occasionally resemble proteins on host cells resulting in host antibodies attacking the host cells
What is the precursor infection that triggers most cases of GBS?
Campylobacter jenuni
What cells are attacked by the immune system in acute inflammatory demyelinating poly neuropathy?
Schwann cells
What do schwann cells do?
Produce myelin sheath around the axons that allow for the rapid conduction of nerve impulses
Why does the patient experience muscular weakness in GBS?
Muscles are fine, but the electrical impulses that are being sent are not reaching the muscles so they are unusable
What is the classic pattern of weakness displayed in GBS?
Weakness presents in an ascending pattern
Lower extremity weakness may present first
Ground to brain
What symptoms of GBS are concerning in regards to respiratory therapy?
Loss of ability to manage oral secretions
Weak cough, secretion accumulation
Respiratory muscle paralysis
Inability to protect airway (dysphagia)
What symptoms or history could lead you to suspect GBS?
Acute onset of mostly symmetrical muscle weakness
Absence of deep tendon reflexes
Symptoms progress over days to 4 weeks
Symptoms preceded by an infection
What are the diagnostic criteria required to diagnose GBS?
Progressive weakness of arms and/or legs ranging from minimal weakness in legs to total paralysis of all four limbs including trunk, bulbar and facial muscles
Decreased deep tendon reflexes in weak limbs
What supportive features would aid in a clinical diagnosis of GBS?
Symptom progression over days to 4 weeks
Relatively symmetric bilateral symptoms
Pain in trunk or limbs
Cranial nerve symptoms or signs
Mild sensory disfunction
No fever at onset
Elevated protein count in CSF
Recovery staring 2-4 weeks after progression halts
