PRESENTATION ON

GUILLAIN BARRE
SYNDROME

GUILLAIN-BARRE SYNDROME
INTRODUCTION:

Guillain _barre syndrome (GBS) is the most common cause of acute,flaccid neuro
muscular paralysis in the United states.guillain barre syndrome was first
discovered more thean century ago.advance in the past century include
investigating the immune _mediated pathophysiology of the diseases recognized
the spectrum of presantations, advancing diagnostic modalites , prognostic
modeles and performing randomized trials of treatments to improve outcomes.
given the morbidty that can occur with out treatment on physicians should have a
knowledge of this rare diseases.

DEFINITION:

Guillain-Barré syndrome (GBS) Or Landry's paralysis

It is a disorder in which the body's immune system attack part of the peripheral
nervous system. It is an acute, progressive, autoimmune, inflammatory
demyelination of polyneuropathy Of the peripheral sensory and motor nerves
and nerve roots.

INCIDENCE:

• 1-2 cases per 1,00000 people annually,

• Men are one and a half times more likely to be affected than women.

• It is the most common cause of acute non-trauma-related paralysis in the

world.

• The syndrome is named after the French physicians Georges Guillain and
Jean Alexander Barre and strohl.
who described it in 1916.

CAUSES
The exits causea of GBS or still not known the candition ofter developed a few
days or of weeks ofter an infection of the digestive or respiratary tract .this
auggesta that they could be relates to GBS.in rare casess the syndrome can occur
fallowing surgery orher indections or immunizations

THER OR SOME KNOWN RISK FACTORS INCLUDING

*Sex: males are slitely more likely to contact GBS

*Age: risk increases with age

*Compylobacter jejuni bacterial infection: a common cause of food poisoning

this infectionns some times occure before GBS

*Influenza virus:Hiv or epstin_ barr virus : this have occures in the associa2 qith
cause of GBS.

*Mycoplasama pnemonia: this is abacterial infection od the lungs.

*surgery: some surgeryies can trigger GBS

*hodgkin ‘s lymphoma: cancer of the lymphatic system can leads to GBS.

*Influenza vaccination or some childhood vaccinations: this have also been

linked to GbS in rare cases.

CLASSIFICATION

1) Acute Inflammatory Demyelinating Polyneuropathy

(AIDP)

• Most common.

• Auto immune response against Schwan cell.

2) MILLER FISHER SYNDROME (MFS)

• Rare variant
 • Manifest as a descending paralysis.

• Usually affects the eye muscles first and presents with the triad of
ophthalmoplegia, ataxia, and reflex ion.

3) ACUTE MOTOR AXONAL NEUROPATHY (AMAN)

• Also known as Chinese paralytic syndrome,

• Attacks motor nodes of Ranvier and is prevalent in China and Mexico.

4) ACUTE MOTOR SENSORY AXONAL NEUROPATHY (AMSAN)

• Similar to AMAN

• Affect the sensory with several axonal damage.

5) ACUTE PAN AUTONOMIC NEUROPATHY

• Is the most rare variant of GBS, sometimes accompanied by

encephalopathy.

• Frequently occurring symptoms include impaired sweating, lack of tear

formation, photophobia, dryness of nasal and oral mucosa, itching and
peeling of skin, nausea, dysphagia, and constipation unrelieved by
laxatives or alternating with diarrhea.

• Initial nonspecific symptoms of lethargy, fatigue, headache, and

decreased initiative are followed by autonomic symptoms including
orthostatic lightheadedness, blurring of vision, abdominal pain,
diarrhea, dryness of eyes, and disturbed micturition.

Bickerstaff's brainstem encephalitis (BBE) .

 • It is characterized by acute onset of ophthalmoplegia, ataxia, disturbance
of consciousness, hyperreflexia. Large, irregular hyper intense lesions
located mainly in the brainstem, especially in the pons, midbrain and
medulla, are describe in the literature.

CLINICAL FEATURES

• The 1st symptoms of Guillain-Barre syndrome is...

1) Pain.

2) Progressive muscle weakness.

3) Diminished reflexes of lower extremities.

4) Prickly, tingling
sensations.

5) Low blood pressure.

6) Parenthesis.

7) Tenderness and
muscle pain.

8) Dysthesias & muscle

spasms.

9) Palpitation.

10) Hearth rate change.

11) Sweating
abnormalities.
12) Cardiac arrhythmia.

13) Neuromuscular respiratory failure.

14) Difficulty in eye movement, facial movement, speaking, chewing, or

swallowing.
DIAGNOSTIC EVALUATION

 Spinal tap (lumbar puncture). A small amount of fluid is withdrawn

from the spinal canal in your lower back. The fluid is tested for a type
of change that commonly occurs in people who have Guillain-Barre
syndrome.
 Electromyography. Thin-needle electrodes are inserted into the
muscles your doctor wants to study. The electrodes measure nerve
activity in the muscles.
 Nerve conduction studies. Electrodes are taped to the skin above your
nerves. A small shock is passed through the nerve to measure the
speed of nerve signals
Criteria

• Progressive weakness in leg & arm & areflexia.

• Features that strongly support diagnosis are progressive
of symptoms over days to 4 week, relatively symmetry
symptoms mild sensory symptoms/signs, cranial nerve
involvement.

MEDICAL TREATMENT

• Plasmapheresis

• High dose immunoglobin therapy Mechanical ventilator

• Pain control

• Supportive care

• Start after the 4th week from the onset.

• Approximately 80% of patient have a complete recovery.

 NURSING MANAGEMENT

• Treatment is non specific and symptomatic.

• Observe continuously for adequacy of respiratory effort.

• . Continuous ECG monitoring.

• Supportive nursing care measures indicated by the patients degree of

paralysis.

• Residual efforts are rare, but prolonged flaccid paralysis lead to muscle
atrophy requiring rehabilitation and physiotherapy.