Guillain–Barré Syndrome

Guillain–Barré Syndrome

Pathology:                   Autoimmune mediated acuteinflammatory demyelinating polyneuropathy resulting in ascending motorparalysis, sensory symptoms and loss of deep tendon reflexes


Aetiology:                    History of preceding viralor diarrheal illness – Associated with campylobacter jejuni


Symptoms:                   Ascending motor weaknessusually starting in the lower limbs and altered sensation.


Signs:                             Paresthesia,areflexia, cranial nerve palsies, symptoms of dysautonomia such as fluctuatingBP, temperature, heart rate

Respiratory muscleweakness can occur in severe cases


Investigations:         Bloods: Serology for virusessuch as EBV, CMV, HIV and Anti-ganglioside antibodies

                                       LumbarPuncture: Increased CSF protein with low cell count

Stool Culture: Screenfor Campylobacter Jejuni

Other: Nerveconduction studies


Treatment:                  Medical: Intravenous immunoglobulins,Plasma exchange and rehabilitation

Monitoring: Cardiac and regularlung function tests

Admission: ITU and ventilationfor respiratory compromise


Complications:          Cardiac arrhythmias, respiratoryarrest, LRTI


Prognosis:                    Majority of patients recoverfully

5-10% left with significantdisability.

Poor prognosis is associatedwith elderly, significant disability at 2 weeks, history of preceding diarrheaand significant abnormality in nerve conduction studies. Recurrence of GBS isvery rare.

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