Peripheral Polyneuropathies (including Guillain-Barré) (3) Flashcards
What is its most common manifestation?
→ What are its characteristics?
What are the causes?
➊ Distal Symmetrical Polyneuropathy (DSPM)
→ • Length-dependent
• “Glove and Stocking” – Feet and distal legs first, hands later
➋ CRAIG DAVID MC:
• Cancer
• Renal
• Amyloid
• Infection (HIV, Lyme)
• Guillain-Barre Syndrome
• Diabetes
• Alcohol
• Vit deficiencies (B12/Folate)
• Inherited (Charcot-Marie Tooth)
• Drugs (Chemo, HIV drugs)
• Metabolic (Hypothyroidism), Metals (Lead)
• Critical care
Guillain-Barre Syndrome:
What is it?
When does it typically occur?
What are the types?
What’s the prognosis?
➊ Acute, symmetrical, ascending weakness +/- sensory symptoms
➋ 1-3 wks post-infection, esp. campylobacter jejuni, cmv, ebv
➌ • AIDP – Acute Inflammatory Demyelinating Polyradiculoneuropathy – Mixed GBS
• AMAN – Acute Motor Axonal Neuropathy – Pure Motor GBS
• AMSAN – Acute Motor Sensory Axonal Neuropathy – Pure Sensory GBS
➍ 80% fully recover, 15% left with some neurological deficit, 5-10% die
How does it present?
→ What is common?
What can occur in severe cases?
→ What will these pts present with?
→ What will these pts require?
➊ • Pain
• Symmetrical weakness, starting distally in lower limbs, and ascending proximally (Paresthesia may occur in the same pattern)
• LMN signs in lower limbs – Hypotonia, Areflexia, Flaccid paralysis
→ Autonomic involvement – Cardiac, Bladder, Bowel
➋ Respiratory muscle involvement
→ T2 RF (i.e. hypoxic CO2 retention)
→ Ventilatory support
How is it investigated?
How is it primarly managed?
What is given in those with significant disability e.g. inability to walk?
➊ * LP – Raised protein w/normal cell count and glucose
* Spirometry – Monitor VC to check for any respiratory involvement
* ABG – Check for T2 RF
* ECG - Cardiac monitoring
* NCS – Reduced signals – Shouldn’t be delayed
* HIV test
➋ Supportive w/analgesia and monitoring (above)
➌ * IVIG
* PLEX
