GUILLAIN BARRE

SYNDROME

Submitted To Submitted By

Miss Shikha Sharma Mr. Neeraj Rathore

Asst. Professor Bsc. Nursing 3rd Year

Kanyakubj Nursing College Indore Kanyakubj Nursing College Indore

 INTRODUCTION

It is a disorder in which the body 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
Nervous And Nerve Roots.
 DEFINITION
Guillain barre syndrome (GBS) is an acute autoimmune disease marked
by inflammation of the peripheral nerves, affecting arms and legs and
involves destruction of the myelin sheath surrounding largest most
myelinated sensory and motor fibers, resulting in disrupted
proprioception and weakness.
 CLASSIFICATION
• Acute Inflammatory Demyelinating Polyneuropathy (AIDP):-
1. Most common.
2. Auto immune response against Schwann cell.

• Miller fisher syndrome (MFS):-

1. Rare varient.
2. Manifestation as a defending paralysis.
3. Usually affect the eye muscles first and present with the triad of
opthalmoplagia,atraxia and areflexia.

• Acute motor axonal neuropathy (AMAN):-

1. Also known as chinese paralytic syndrome.

2. Attacks motor nodes of ramvier and is prevalent in china and maxico.
Continue.........

• Acute motor sensory axonal neuropathy (AMSAN):-

1. Similar to aman.
2. Affect the sensory with several axonal damage.

• Acute panuotonomic neuropathy:-

1. It is the most rare varient of GBS sometimes accompained by encephalopathy.
2. Frequently occurring symptoms include impaired sweating , lack of tear formation,
photophobia, dryness of nasal , and oral mucosa, etching and peeling of skin,
nausea, dysphagia and constipation unrelieved by laxatives or ulternative diarrhea.
 INCIDENCE

• 1- 2 case per 1,00000 people annually.

• Men are one and a half time’s more likely to be affected then a
women.

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

the world.

• The Syndrome is named after the FRENCH Physician GEORGES

GUILLAIN and JEAN ALEXANDRE BARRE and STROHL who
Described it in 1916.
 CAUSES
• Influenza Vaccine

1. 1 case per 1 million Vaccination

• Gastrointestinal and respiratory infections.

1. Campylobacter Infection ( watery/bloody diarrhea.

2. Influeza infection .

• Surgery.

1. Trauma.
 RISK FACTORS

• Most commonly , Infection With Campylobacter , A type of bacteria often

found in under cooked Polutry.

• Influenza Virus.

• Cytomegalovirus.

• Zika virus .

• Surgery .

• Trauma.
 SING AND SYMPTOMS
. Progressive Muscle Weakness.

. Low blood pressure.

. Paresthesis.

. Tenderness and Muscle pain .

. Palpitations.

. Cardiac arrhythmia .

. Neuromuscular respiratory failure.

 DIAGNOSTIC EVALUATION

• Medical History.
• Physical examination .
• Tests.
• Nerve conduction studies .(NCS).
• CSF examination .
• Electromyograph (EMG).
• Electrocardiogram (ECG).
• Pulmonary function test (PFT).
 MANAGEMENT
• Medical Management:-
• Intravenous Immunoglobulin Therapy:-

• Prevents Immune system from further attacking Schwann cells and

Myelin by blocking receptors on Microphages.
• Plasmapheresis:-
1. Filters blood Plasma to Remove Antibodies and aids in Replacing lost
Fluids.
• Corticosteroids :-
1. Inhibit inflammation associated by symptoms.
• Neurontin:-
1. Helps reduce neuropathic pain.
• Elavil:-
1. Helps Reduce neuropathic pain .
 NURSING MANAGEMENT

• Treatment is non specific and sympathetic.

• Observe continuously for adequency of respiratory effort .
• Continuous ECG Monitoring.
• Supportive Nursing Care measures Indicated by the patient’s degree of
paralysis.
• Residual efforts are rare,but Prolonged Fluccid Paralysis lead to
Muscle Atrophy requiring rehabilitation and Physiotherapy.
 NURSING DIAGNOSIS

• Ineffective airway clearance related bro respiratory moscle weakness /

dysphagia.
• Impaired sensory perception related to disease process .
• Imbalanced nutrition related to dysphagia.
• Anxiety related to serve chest pain .
• Deficient knowledge regarding the disease proces.
 HEALTH EDUCATION
• Advise patient and family that acute phase lasts 1to4 weeks ,than patient
stabilizes and rehabilitation can begin , however ,çonvolescence mar be
lengthy from 3 month to 2 years .
• Instract patient in breathing exercise or use of incentive spirometer to
restablish normal patterns .
• Teach patient to wear good supportive and protective shoes while out of
bed to prevent injuries due to weakness and paresthesia.
• Balanced diet .
• Encourage the use of schedule rest periods to avoid over fatigue .
• Reinforce maintanance of normal weight , additional weight Wii further
stress the motor abilities .
 PROGNOSIS
• Even with appropriate treatment ,3% of patients with Guillain –Barre
Syndrome will die .
• 25% of patients will require mechanical ventilation which Increase
mortality risk.
• Prognosis is wrose in pt.with rapid onset of symptoms ,severe
symptoms and in elderly patients .
• Neurological deficit persist in 20% of pt.half of these remain severly
disbled .
• Up to 80% patient experience persist , severe fatigue after resolution of
other symptoms.
 CONCLUSION
• GBS is an acute Inflammation Demyelinating Polyneuropathy
characterized by Progressive symmetric ascending music weakness ,
Paralysis,and hyporeflexia with or without sensory or autonomic
symptoms .
• GBS is believed to result from autoimmune , humoral and cell
mediated response to a recent in infections or any of a long list of
medical problems.