Guillain Barre Syndrome (GBS) is a serious disorder that occurs when the body’s defense (immune) system mistakenly attacks part of the nervous system i.e Autoimmune Disorder.

1. GUILLAIN-BARRE SYNDROME
DR. MUKESH SAH
PURBANCHAL CANCER HOSPITAL
DEPARTMENT OF NEUROSURGERY
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2. INTRODUCTION
• Guillain Barre Syndrome (GBS) is a serious disorder that occurs when
the body’s defense (immune) system mistakenly attacks part of the
nervous system i.e Autoimmune Disorder.
• This leads to nerve inflammation that causes muscle weakness.
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3. Pathophysiology
• Guillain Barre Syndrome (GBS) is a rare and severe disease.
• It occurs after an acute infectious procedure (Campylobacter jejuni,
CMV, EBV, M.pneumonia)- precedes days to week.
• Antibody-mediated attack.
• Molecular mimicry- antibodies cross react with myelin or axons.
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4. NEURON
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5. Risk factors
In men more likely than woman
• Recent gastrointerstinal or respiratory infection by viruses or bacteria
• Recent vaccination (especially influenza and meningococcal)
• Recent surgery
• History of lymphoma, Systemic lupus erythromatosus, or HIV and
AIDS
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6. TYPES:
• There are 6 different subtypes of GBS and they are:
• Acute Inflammatory demyelinating polyneuropathy(AIDP)-most
common
• Miller Fisher syndrome-descending variety
• Acute motor axonal neuropathy
• Acute motor sensory axonal neuropathy
• Acute panautonomic neuropathy
• Bickerstaff’s brainstem encephalitis
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7. Clinical Features:
• Progessive, symmetric ascending paralysis –lower to upper limbs
• More marked in legs than arms and proximally than distally.
• Motor > Sensory paralysis.
• Reflexes- hypoactive or absent.
• Sensory symptoms- paraesthesia in hands/feet often present.
• Facial/oropharyngeal weakness in 70% patients.
• 25-30% patients- respiratory failure – intubation.
• Bladder dysfunction- later and severe cases.
• Pain(back,hips,thigh)- among MC symptom in paediatrics cases.
• Autonomic instability(60%)- tachy/bradycardia, hypo/hypertension, ileus.
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8. C/f:
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9. Diagnosis
• LP AND CSF STUDY: CYTO-ALBUMINEMIC DISSOCIATION
CSF protein: raised (may be normal in first 10 days)
CSF TLC : usually no increase
• Nerve conduction study (NCS) and Electromyography (EMG)
• Antibodies to ganglioside GM1- 25%- usually in motor axonal form.
• Rule out other causes – polio, botulism, myasthenia, transverse
myelitis etc.
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10. TREATMENT
• 1) Intravenous immunoglobulin (IVIg)
- 0.4 gm/kg daily infusion for 5 days
- within 2 weeks of 1st motor symptoms
- neutralises GBS autoantobodies
• 2) Plasmapheresis
- 40-50 ml/kg 4 times a week.
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11. Supportive Measures
• ECG and SpO2 monitoring
• Pain management
• DVT prophylaxis
• Physiotherapy
• Bed sore care
• Tracheostomy
• Daily reassurance
• Rehabilitation measures for daily life activities
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12. Prognosis
• 80% patients- recover completely within 3-6 months
• 4%- Die
• Remaining patients- residual neurological disability- can be severe.
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13. YESSSS!!!
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