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Name: Devaras, Lecah May C. Yr&Sec: BSN III Our Lady of Hope

GUILLAIN-BARRE SYNDROME
DESCRIPTION
Guillain-Barré (Ghee-YAN Bah-RAY)
syndrome (GBS) is a rare, autoimmune
disorder in which a person’s own
immune system damages the nerves,
causing muscle weakness and sometimes
paralysis. GBS is a serious autoimmune
disease that can affect any part of the
nervous system outside the brain and
spinal cord. This is called the peripheral
nervous system.
An autoimmune disease causes the
immune system to attack and destroy
certain groups of healthy cells. In the case
of GBS, it attacks the myelin sheaths of
peripheral nerves. Myelin sheaths coat the
axons of nerves. The myelin helps these
long, thin extensions of nerve cells pass on
messages. In some cases, GBS also attacks
the axons themselves. The damage
prevents the nerves from sending certain
information, such as touch sensations, to
the spinal cord and brain. This causes a
feeling of numbness. In addition, the brain
and spinal cord can no longer transmit
signals back to the body, leading to muscle
weakness.
GBS can cause symptoms that last for a
few weeks to several years. Most people recover fully, but some have permanent nerve
damage. Some people have died of GBS. There's no known cure for Guillain-Barre syndrome,
but several treatments can ease symptoms and reduce the duration of the illness.
TYPES
Once thought to be a single disorder, Guillain-Barre syndrome is now known to occur in several
forms. The main types are:
 Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common
form in North America and Europe. The most common sign of AIDP is muscle weakness
that starts in the lower part of your body and spreads upward.
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 Miller Fisher syndrome (MFS), in which paralysis starts in the eyes. MFS is also
associated with unsteady gait. MFS is less common in the U.S. but more common in
Asia.
 Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy
(AMSAN) are less common in the U.S. But AMAN and AMSAN are more frequent in
China, Japan and Mexico.

CAUSES & RISK FACTORS

Cause:
The exact cause of Guillain-
Barre syndrome isn't known.
The disorder usually appears
days or weeks after a
respiratory or digestive tract
infection. Rarely, recent
surgery or vaccination can
trigger Guillain-Barre
syndrome. Recently, there have
been cases reported following
infection with the Zika virus.
Guillain-Barre syndrome may
occur after infection with
the COVID-19 virus. It's also a
rare reaction in those who
receive the Johnson & Johnson COVID-19 vaccine.
People have developed GBS after infection with:
 Campylobacter jejuni bacteria, which can cause a bowel infection and diarrhea
 the Epstein-Barr virus, which causes infectious mononucleosis, or glandular fever
 cytomegalovirus, which may cause no symptoms
 Mycoplasma pneumoniae bacteria, which can infect the respiratory tract
 possibly the Zika virus, through researchers are still investigating this

In Guillain-Barre syndrome, your immune system — which usually attacks only invading
organisms — begins attacking the nerves. In AIDP, the most common form of Guillain-Barre
syndrome in the U.S., the nerves' protective covering (myelin sheath) is damaged. The damage
prevents nerves from transmitting signals to your brain, causing weakness, numbness or
paralysis.
Risk Factors
Guillain-Barre syndrome can affect all age groups. But your risk increases as you age. It's also
more common in males than females.
Guillain-Barre syndrome may be triggered by:
 Most commonly, infection with campylobacter, a type of bacteria often found in
undercooked poultry
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 Influenza virus
 Cytomegalovirus
 Epstein-Barr virus
 Zika virus
 Hepatitis A, B, C and E
 HIV, the virus that causes AIDS
 Mycoplasma pneumonia
 Surgery
 Trauma
 Hodgkin's lymphoma
 Rarely, influenza vaccinations or childhood vaccinations
 COVID-19 virus
 COVID-19 Johnson & Johnson vaccine

PATHOPHYSIOLOGY

SIGNS & SYMPTOMS

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Guillain-Barre syndrome often begins with tingling and
weakness starting in your feet and legs and spreading to your
upper body and arms. In about 10% of people with the
disorder, symptoms begin in the arms or face. As Guillain-Barre
syndrome progresses, muscle weakness can evolve into
paralysis.
Signs and symptoms of Guillain-Barre syndrome may include:
 Prickling, pins and needles sensations in your fingers,
toes, ankles or wrists
 Weakness in your legs that spreads to your upper body
 Unsteady walking or inability to walk or climb stairs
 Difficulty with facial movements, including speaking,
chewing or swallowing
 Double vision or inability to move eyes
 Severe pain that may feel achy, shooting or cramp like
and may be worse at night
 Difficulty with bladder control or bowel function
 Rapid heart rate
 Low or high blood pressure
 Difficulty breathing
 Paralysis
 People with Guillain-Barre syndrome usually experience their most significant weakness
within two weeks after symptoms begin.
DIAGNNOSIS/LABORATORY TEST
Guillain-Barre syndrome can be difficult to diagnose in its earliest stages. Its signs and
symptoms are similar to those of other neurological disorders and may vary from person to
person.
Your doctor is likely to start with a medical history and thorough physical examination.
A doctor will consider:
 Whether the weakness affects both sides of the body
 How fast the symptoms have appeared
 The order in which they have appeared
Your doctor may then recommend:
 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.
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 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.

MEDICAL MANAGEMENT
There's no cure for Guillain-Barre syndrome. The goal of treatment is to lessen the severity of
the immune attack and support your body functions, such as lung function, while your nervous
system recovers.
But two types of treatments can speed recovery and reduce the severity of the illness:
 Plasma exchange (plasmapheresis). During this procedure, a machine is used to remove
blood from your body. This machine removes the antibodies from your blood and then
returns the blood to your body. The liquid portion of part of your blood (plasma) is
removed and separated from your blood cells. The blood cells are then put back into
your body, which manufactures more plasma to make up for what was removed.
Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the
immune system's attack on the peripheral nerves. The goal of plasmapheresis is to
remove the antibodies attacking the nerves from your blood.
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 Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood

donors is given through a vein (intravenously). High doses of immunoglobulin can block
the damaging antibodies that may contribute to Guillain-Barre syndrome.

These treatments are equally effective. Mixing them or administering one after the other is no
more effective than using either method alone.
You are also likely to be given medication to:
 Relieve pain, which can be severe
 Prevent blood clots, which can develop while you're immobile

People with Guillain-Barre syndrome need physical help and therapy before and during
recovery. Your care may include:
 Movement of your arms and legs by caregivers before recovery, to help keep your
muscles flexible and strong
 Physical therapy during recovery to help you cope with fatigue and regain strength and
proper movement
 Training with adaptive devices, such as a wheelchair or braces, to give you mobility and
self-care skills

NURSING MANAGEMENT

 Monitor respiratory status through vital capacity measurements, rate and depth of
respirations, and breath sounds.
 Monitor level of muscle weakness as it ascends toward respiratory muscles. Watch for
breathlessness while talking which is a sign of respiratory fatigue.
 Monitor the patient for signs of impending respiratory failure.
 Monitor gag reflex and swallowing ability.
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 Position patient with the head of bed elevated to provide for maximum chest excursion.
 Avoid giving opioids and sedatives that may depress respirations.
 Position patient correctly and provide range-of-motion exercises.
 Provide good body alignment, range-of-motion exercises, and change of position to
prevent complications such as contractures, pressure sores, and dependent edema.
 Ensure adequate nutrition without the risk of aspiration.
 Encourage physical and occupational therapy exercises to help the patient regain
strength during rehabilitation phase.
 Provide assistive devices as needed (cane or wheelchair) to maximize independence and
activity.
 If verbal communication is possible, discuss the patient’s fears and concerns.
 Provide choices in care to give the patient a sense of control.
 Teach patient about breathing exercises or use of an incentive spirometer to reestablish
normal breathing patterns.
 Instruct patient to wear good supportive and protective shoes while out of bed to
prevent injuries due to weakness and paresthesia.
 Instruct patient to check feet routinely for injuries because trauma may go unnoticed
due to sensory changes.
 Urge the patient to maintain normal weight because additional weight will further stress
monitor function.
 Encourage scheduled rest periods to avoid fatigue.

COMPLICATIONS

Guillain-Barre syndrome affects your nerves. Because nerves control your movements and body
functions, people with Guillain-Barre may experience:
 Breathing difficulties. The weakness or paralysis can spread to the muscles that control
your breathing, a potentially fatal complication. Up to 22% of people with Guillain-Barre
syndrome need temporary help from a machine to breathe within the first week when
they're hospitalized for treatment.
 Residual numbness or other sensations. Most people with Guillain-Barre syndrome
recover completely or have only minor, residual weakness, numbness or tingling.
 Heart and blood pressure problems. Blood pressure fluctuations and irregular heart
rhythms (cardiac arrhythmias) are common side effects of Guillain-Barre syndrome.
 Pain. One-third of people with Guillain-Barre syndrome experience severe nerve pain,
which may be eased with medication.
 Bowel and bladder function problems. Sluggish bowel function and urine retention may
result from Guillain-Barre syndrome.
 Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of
developing blood clots. Until you're able to walk independently, taking blood thinners
and wearing support stockings may be recommended.
 Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure
sores). Frequent repositioning may help avoid this problem.
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 Relapse. From 2% to 5% of people with Guillain-Barre syndrome experience a relapse.

Severe, early symptoms of Guillain-Barre syndrome significantly increase the risk of serious
long-term complications. Rarely, death may occur from complications such as respiratory
distress syndrome and heart attacks.