Guillain-Barre Syndrome
Title
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Guillain-Barre Syndrome (Acute
Inflammatory Demyelinating Polyradiculoneuropathy, AIDP)
Definition
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An acute inflammatory
demyelinating polyradiculoneuropathy
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Mainly motor
Pathogenesis
Causes
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Probably an autoimmune process
triggered by recent infection
The infections that may trigger the process
are:
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Enterovirus
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Mycoplasma
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Campylobacter
jejuni
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Cytomegalovirus
Pathological Process
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Chronic inflammation involving
the nerve roots
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Segmental demyelination
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Nerve conduction velocity slowed
Clinical Features
History
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Presents 1-3 weeks following an
infection
GIT
Autonomic neuropathy causes:
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Nausea
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Vomiting
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Constipation
CNS
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Weakness
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Numbness
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Begins distally and ascends
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Progression:
From several days to 21 days
Examination
CVS
Autonomic neuropathy causes:
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Tachycardia
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Hypertension
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Hypotension
CNS
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Reduced tone
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Weakness
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Loss of reflexes
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Diminished sensation
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Cranial nerve involvement less
common:
Bilateral facial weakness
Bulbar palsy
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Bladder dysfunction:
Rare
Investigations
Fluids
Cerebrospinal Fluid
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Protein raised:
1-10g/L
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Cell count and sugar:
Normal
Management
Control
Drugs
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Intravenous immunoglobulin:
Reduces duration and severity of the paralysis
Equipment
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Plasmapheresis:
Shortens duration of disability
Support
RS
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Ventilatory support:
May be required if respiratory
paralysis occurs
