Condition Info - BotMed Application

ConditionName

Guillain-Barré Syndrome (GBS)

ConditionDescription

Acute inflammatory polyneuropathy. Autoimmune damage of multiple peripheral nerves.

Symptoms

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 cramplike and may be worse at night;
Difficulty with bladder control or bowel function;
Difficulty breathing;

PhysicalFindings

Low or high blood pressure;
Autonomic instability: BP goes up and down
Rapid heart rate;
Autonomic dysfunction in 70% - tachycardia;
Weakness of both legs, loss of DTPs;
Respiratory muscle weakness;
May include bilateral facial paralysis (R/O Lyme);
Facial muscle weakness and/or oropharyngeal weakness – 50%;
ASCENDING symmetric muscle weakness and loss of reflexes, progresses over 2-4 weeks;
No fever, no sensory abnormalities;

ClinicalTests

Clinical evaluation;
Cerebrospinal fluid (CSF) analysis;
NO CNS involvement!

Most specific test: nerve conduction study/electromyography (EMG): decrease in propagation of electrical impulses along nerves  
Evidence of demyelination;

PFT: decrease in FVC – most important to prevent resp failure in ER;
CSF: albumin cytologic dissociation (elevated protein, normal WBC);

RiskFactors

Associated with Campylobacter jejuni 20%;
HIV;
CMV;
EBV;
Mycoplasma;
Other viral infections;
Sometimes recent immunisation;

IsRedFlag

IsNPLEX

Consequence

Death from respiratory failure (diaphragm related) in 30% and dysautonomia;
INHEALATION problem;

Spontaneous recovery within 1 year 80-90%;
5% mortality

ProgressionFromCondition

TreatmentOptions

PharmOptions

IVIG or plasmapheresis works for 50%

NO STEROIDS! Never!

WebLink

https://www.merckmanuals.com/en-ca/professional/neurologic-disorders/peripheral-nervous-system-and-motor-unit-disorders/guillain-barré-syndrome-gbs