Gullain-Barre

Syndrome
Presented by: Kate Janelle Cajucom And Angelo Silvestre
Background
• GBS was first described by two French
neurologists, Georges Guillain and Jean Barré,
in 1916.
• It is an autoimmune disorder, where the
immune system mistakenly attacks the myelin
sheath and nerve fibers in the peripheral
nervous system.
• The exact cause of GBS is not well
understood, but it is often triggered by
viral or bacterial infections, such as
respiratory or gastrointestinal infections.
Prevalence
• GBS is considered a rare disease, with an estimated
annual incidence of 1-2 cases per 100,000 people in the
general population.
• It can affect individuals of all ages but is most
common in adults, particularly those in their 30s
and 40s.
 Main
Problem
• Can affect the nerves
that control muscle
movement as well as
that transmit pain,
temperature and touch
sensations.
 Etiologic
Agent
• Infection with Campylobacteria
jejuni, which causes diarrhea, is
one of the most common
causes of GBS. About 1 in
every 1,000 people with
campylobacteria infection in the
United States gets GBS.
 Etiology
● Bacterial infection
● Viral infection
● Protozoan Infection
● Surgeries
● Blood Transfusion
● Transplantation
● anesthesia
● Preceding Heat stroke
● Preceding Vaccination - Swine flu
 Incubation
Period
● The three Phases of GBS are
the progressive phase (lasting
from days to 4 weeks), A
plateau phase with little
clinical change (lasting from
days to months), and a
recovery phase.
 Mode of
Transmission

● It is not contagious or inherited

 Guillain-Barre
syndrome has
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.

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.
 Manifestation
Tingling and weakness starting in
your feet and legs and spreading to
your upper body and arms
● Limb Weakness
● Difficulty Swallowing
● Shortness of breath
● Flaccid Paralysis
 Risk Factor
Guillan-barre Syndrome may be
triggered by:
● Most commonly, Infection with
campylobacteria, a type of bacteria
often found in undercooked poultry
● Influenza virus
● Cytomegalovirus
● Epstein-barr Virus
● Zika virus
● Hepatitis A,B,C, And E
 Risk Factor
Guillan-barre Syndrome may be
triggered by:
● HIV, the virus that causes AIDS
● Mycoplasma Pneumonia
● Surgery
● Trauma
● Hodgkin’s Lymphoma
● Rarely, Influenza Vaccination or
Childhood Vaccinations
● Covid-19 infection
Signs and Symptoms
• The onset of GBS is often sudden and typically
starts with weakness and tingling sensations in the
legs and sometimes in the arms.
• Common signs and symptoms include muscle weakness or
paralysis that progresses over days or weeks, loss of
reflexes, pain, and difficulty with coordination and balance.
• Some individuals may also experience sensory
disturbances, including numbness or tingling.
• In severe cases, GBS can lead to respiratory muscle
weakness, requiring mechanical ventilation to support
breathing.
 Complications
● Breathing difficulty
● Residual Numbness
● Blood pressure Fluctuations and
irregular heart rhythms (Cardiac
arrhythmias)
● Sluggish Bowel function and urine
retention
● Pain
● Blood clots
● Pressures sores
 Diagnostic Procedure
● Spinal tap (lumbar puncture). A small
amount of fluid is withdrawn from the
spinal canal in your lower back.

● Electromyography. Thin-needle
electrodes are inserted into the
muscles your doctor wants to study.

● Nerve conduction studies. Electrodes

are taped to the skin above your
nerves.
 Nursing Diagnosis
● Ineffective Breathing Pattern
● Acute Pain
● Impaired Physical Mobility
● Impaired Urinary Elimination
● Anxiety
Medical & Clinical Management
• GBS is considered a medical emergency, and treatment is primarily
aimed at reducing the severity and duration of the illness.
• Intravenous immunoglobulin (IVIG) and plasma exchange
(plasmapheresis) are the main treatments used to modify the
immune response and reduce inflammation.
• Supportive care is essential, as individuals with severe GBS may
require hospitalization for respiratory support and close monitoring.
• Physical therapy and rehabilitation play a crucial role in helping
patients regain muscle strength and function once the acute phase of
the illness is over.
• The recovery process can be slow, and some individuals may
experience residual weakness or neurological symptoms that require
long-term management.
 Nursing Management
● Autonomic dysfunction with
orthostatic hypotension and
tachycardia.
● Check for previous history of viral
illness or surgical procedure.
Urinary Incontinence.
● Check for facial nerve paralysis.
● Inspect the patient's face at rest and
during conversation.
 Nursing Management
● Assess for any problems during
talking, swallowing and chewing.
● Assess for any change in the vital
signs.
● Maintaining respiratory function
incentive spirometry and chest
physiotherapy.
Nursing Management
Mechanical ventilation
• Close monitoring and suctioning
• Enhancing physical mobility
passive range-of-
motion exercises are performed at least
twice daily.
• providing adequate
nutrition IV fluids and
parenteral nutrition.
Nursing Management
• monitors for the return of bowel sounds
gastrostomy tube assesses the return of
the gag reflex
• Monitoring and managing potential
complications
Thorough assessment of respiratory
function at regular intervals cardiac
dysrhythmias, which necessitate ECG
monitoring
 Nursing Intervention

1. Obtain and monitor vital signs frequently

2. Monitor pulse oximetry frequently
3. Assess depth of respirations and type of
breathing pattern.
4. Elevate head of the bed, and maintain patient at
Semi Fowler’s Position
5. Change Position every 2 hours
6. Instruct and encourage patient to do deep
breathing exercises
7. conserve patient’s strength by providing
adequate rest periods and assisting with
activities
 Nursing Intervention

8. Provide and assist in using incentive spirometer,

as ordered by the doctor

9. Administer respiratory medications, as

prescribed by the physician

Collaborative

10. Collaborate with physician and pulmonologist,

as indicated.
 Nursing Intervention
● Close monitoring of respiratory
function
● If on a mechanical ventilator:
Reassurance
● Nutritional maintenance via IV or
G-tube
● Prevention of complications : turning,
skin care, pressure relief, ROM
measures
Pathogenesis
• GBS is believed to result
from an autoimmune
response, where the body's
immune system produces
antibodies that target
components of the
peripheral nervous system.
• This immune response
damages the myelin sheath
and the nerve fibers,
disrupting the normal
function of nerve signals.