Overview
Clinical Manifestations/Presentation
Diagnostics
100
GBS is an acute immune-mediated ____ that typically presents with flaccid paralysis and sensory involvement
Polyneuropathy
100
Typically limb involvement in Guillain-barre typically starts here
Lower limbs and then ascends, typically bilaterally
100
Main treatment options for GBS include
Intravenous Immunoglobulins
or
Plasmapheresis
We also want to monitor respiratory muscle function and autonomic function
200
What percent of patients with GBS regain the ability to walk unaided 6 months after symptom onset
Approximately 80%
Up to 20% of patients remain severely disabled and approximately 5% of patients die despite medical treatment
200
Paresthesia in GBS typically has this characteristic distribution
Stocking-Glove distribution
200
The most common disease associated with GBS is
Campylobacter jejuni - causes inflammatory gastroenteritis
Transmission through fecal oral or through ingestion of undercooked, contaminated meat or unpasteurized milk
Gram - : Lipopolysaccharide in outer membrane is similar to gangliosides (A component of peripheral nerves)
Others: CMV, HIV,
300
Pain in these areas are often an early symptom of GBS and affect approximately 2/3 of patients
Back and Limb Pain
Involves nociceptive and neuropathic pain
300
This strength/lack of strength reflex typically begins in the lower limbs with GBS
Hyporeflexia or Areflexia
300
Autoantibodies from against peripheral Schwann cells, unknown antigens and this other molecule that are particularly abundant in the CNS and PNS, where they play an important role in the development and regeneration of neuronal cells
Gangliosides
Particularly include anti-GM1, anti-GD1A, anti-GT1A, and GQ1B. Different antibodies are associated with different variants of GBS
Although these laboratory studies usually require some time to obtain results and therefore may not be as helpful in decision making at the time of patient admission
400
65% of patients with GBS have this before the onset of symptoms
Upper respiratory or gastrointestinal infection
Symptoms of GBS peak at 2-4 weeks
400
Cardiac arrhythmias, blood pressure fluctuations, urinary and/or intestinal dysfunction can occur in GBS due to dysfunction of this part of the nervous system
Autonomic Dysfunction
400
CSF analysis shows this type of dissociation
Albuminocytologic (High protein, Normal WBC)
CSF protein count may be normal if done within 1 week of symptom onset
Rise in protein is thought to be due to disruption of the blood-csf barrier due to nerve inflammation
500
This attacks antigens in the myelin sheath, other Schwann-cell antigens, and axon membranes
Autoantibodies
500
GBS can impact CN 3-12, what is the most common CN symptom associated with GBS
Facial Diplegia (Bilateral facial palsy)
Due to bilateral facial nerve involvement
500
Nerve conduction studies in GBS typically show
Decreased Nerve Conduction Velocity
(Signs of demyelination)
Prolonged H-reflexes and/or F wave latencies are also common early electrodiagnostic findings in GBS