Guillain Barre syndrome (GBS).

Guillain Barre Syndrome (GBS).

Clinical features of Guillain Barre Syndrome (GBS).

Investigation of Guillain Barre Syndrome (GBS).

Treatment of Guillain Barre Syndrome (GBS).

Other name:ย  Acute inflammatory demyelinating polyneuropathy.

Aetiology :This develops 1-4 weeks after respiratory infection or diarrhoea (particularly Campylobacter) in 70% of patients.

Management of Guillain Barre syndrome (GBS):

History of GBS :

1) Recent respiratory tract infection

2) Recent dysentery

Clinical features of Guillain Barre Syndrome (GBS):

1.. Pain and tenderness in the muscle of neck, back, buttock and leg at the onset

2. Symmetrical motor weakness-ascending type

3. Respiratory paralysis presented as

  • Dysponea
  • Prominence of accessory muscle of respiration
  • Progressive elevation of respiratory rate
  • Cyanosis
  • Tachycardia
  • Agitation, confusion, coma

4.ย  Bulbar palsy (50%) characterized by-

  • Dysarthria
  • Dysphagia
  • Facial weakness
  • Dysphonia
  • Poor cough and susceptibility to aspiration pneumonia

5. Autonomic involvement:

  • Fluctuation of Heart rate & BP
  • Body temperature Urinary retention
  • Loss of sweating

6. Sensory symtoms : Less striking

7. Bladder dysfunction : usually absent.

8. Back pain: Radiculopathy.

Investigations of Guillain Barre Syndrome (GBS):

1.. CSF study (albuminocytological disassociation):

  • Cytology : usually normal.
  • Biochemistry: Increased protein.
  • Glucose: normal

2. Stool culture: Cjejuni may be found.

3. Motor nerve conduction velocity: Reduced velocity

4. Electromyogram (EMG): Show evidence of acute denervation of muscle.

5. MRI of Spinal cord: Shows thickening of cauda equina.

Treatment of Guillain Barre Syndrome (GBS):

1. Specific Treatment of GBS:

  • Intravenous immunoglobulin (IVIG).
  • Plasmapheresis
  • Corticosteroid: No role

2. Supportive treatment of GBS.

  • Counsel the parent about the disease, prognosis and to provide psychological support.
  • Monitoring of SPO, by pulse oximeter
  • Bed rest
  • Feeding : NG tube feeding
  • Maintain personal hygiene
  • Care of bowel
  • Care of bladder
  • Assisted ventilation if respiratory failure
  • Management of neuropathic pain by gabapentin.

Overview of Guillain Barre Syndrome (GBS)

Pathogenesis :

Cell-mediated inflammatory response directed at the myelin protein of spinal roots, peripheral and extra-axial cranial nerves triggered by molecular mimicry between epitopes found in the cell walls of some micro- organisms and gangliosides in the Schwann cell membranes

The resulting release of inflammatory cytokines blocks nerve conduction and is followed by a complement- mediated destruction of the myelin sheath and the associated axon, if it is severe.

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    ื›ืืŸ ืชื•ื›ืœื• ืœืžืฆื•ื ื ืขืจื•ืช ืœื™ื•ื•ื™ ื‘ืจืžื” ื”ื’ื‘ื•ื”ื” ื‘ื™ื•ืชืจ, ื ืขืจื•ืช ื™ืคื•ืช ื•ื ืขื™ืžื•ืช ืฉืคืฉื•ื˜ ื›ื™ืฃ ืœื‘ืœื•ืช ืื™ืชืŸ. ื”ืŸ ืชืžื™ื“ ืžื‘ื™ืื•ืช ืื™ืชืŸ ืื•ื•ื™ืจื” ืฉืœ ืฉืžื—ื”, ืขื•ื ื’ ื•ื”ื’ืฉืžืช ืคื ื˜ื–ื™ื•ืช. ื›ืืŸ ื‘ืคื•ืจื˜ืœ ื›ื™ื•ืคื™ื ืชื•ื›ืœื• ื‘ืงืœื•ืช ืœืžืฆื•ื ื ืขืจื•ืช ืœื™ื•ื•ื™ ืžืื•ืžืชื•ืช ื•ื‘ืขืœื•ืช ืชืžื•ื ื•ืช ืืžืชื™ื•ืช. ืื ื‘ื ืœื›ื ืœืคื ืง ืืช ืขืฆืžื›ื ืื• ืœืชืช ื ืขืจืช ืœื™ื•ื•ื™ ื‘ื™ืจื•ืฉืœื™ื – ืคื™ื ื•ืง ื›ื‘ื™ืจ ื‘ืขื™ืจ ื”ื‘ื™ืจื”

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  34. BrettCoM says:

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  35. Andrewtib says:

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