Neurological disorder

1. BY –
SHUBHRIMA KHAN

2. • The nervous system comprises of two groups of cells, glial cells and
neurons.
• Neurons are responsible for sensing change in their environment and
communicating with other neurons via electrochemical signals.
• Glial cells work to support, nourish, and insulate neurons, also
removing the waste products of metabolism.
INTRODUCTION

5. • Guillain Barre syndrome is a rare disorder in which body's immune
system attacks attack part of the peripheral nervous system.
• The nerve injury often causes muscle weakness, cause paralysis and
sensitivity problems, including pain, tingling or numbness.
CONT..

6. It is an acute, progressive, autoimmune,
inflammatory demyelination of the peripheral
sensory and motor nerves.
DEFINITION

8. • Certain infections
Bacterial: campylobacter
Viral: influenza, cytomegalovirus, Epstein Barr, hepatitis, HIV
• Surgeries
• Blood Transfusion
• Transplantation
• Anesthesia
• Preceding vaccination – Swine flu
ETIOLOGY & RISK FACTORS

9. PATHOPHYSIOLOGY

11. 1) Acute Inflammatory Demyelinating Polyneuropathy (AIDP)
• Most common.
• Auto immune response against Schwann cell.
• The most common sign of AIDP is muscle weakness that starts in
the lower part of the body and spreads upward.
CLASSIFICATION

12. 2) Miller Fisher Syndrome (MFS)
• Rare variant
• Manifest as a descending paralysis.
• Usually affects the eye muscles first and presents with the triad of
ophthalmoplegia, ataxia and areflexia.
CONT..

13. 3) Acute Motor Axonal Neuropathy (AMAN)
• Also known as Chinese paralytic syndrome.
• Attacks motor nodes of Ranvier and is prevalent in China and
Mexico.
4) Acute Motor Sensory Axonal Neuropathy (AMSAN)
• Similar to AMAN
• Affect the sensory with several axonal damage.
CONT..

15. • Hyporeflexia and weakness progress and may result in quadriplegia.
• Neuromuscular respiratory failure - demyelination of the nerves that
innervate the diaphragm and inter costal muscles.
• Cranial Nerve deficit in (III- VII, IX- XII) with facial palsy
• Ptosis, diplopia, facial weakness, dysarthria, dysphagia with pooling of
secretions.
• Sensory dysfunction: Gloves and stocking paresthesia's with slight
disturbances of sensibility.
CLINICAL MANIFESTATIONS

16. • Weakness spreads to the arms and upper body.
• The weakness may increase until muscles cannot be used at all and may
result in paralysis.
• Inability to walk due to muscle weakness and paralysis.
• Difficult to speaking, chewing and swallowing, various muscles
required to form speech are weakened.
CONT..

17. DIAGNOSTIC EVALUATION
• Spinal tap (lumbar puncture) & CSF analysis: The fluid is tested for
a type of change – elevated protein content up to 700 mg/dl. Normal-
15-45 mg/dl

18. CONT..
• Electromyography: The electrodes measure nerve activity in the
muscles.

19. CONT..
• Nerve conduction studies: Electrodes are taped to the peripheral
nerves. A small shock is passed through the nerve to measure the
speed of nerve signals.

20. CONT..
• Pulmonary Function Test (PFT)

21. MEDICAL MANAGEMENT
Treatment is non specific and symptomatic.
• Supportive care
• Ventilatory support
• Plasmapheresis (plasma exchange)– to remove abnormal antibodies
• IV Immunoglobulin's – stop antibody damaging cells.
• Immunomodulatory intravenous immunoglobulin
– Muscle weakness
– Respiratory depression

22. NURSING MANAGEMENT
• Observe continuously for adequacy of respiratory effort.
• Continuous ECG monitoring
• Assess for Autonomic dysfunction with orthostatic hypotension and
tachycardia.
• Check for previous history of viral illness or surgical procedure.
• Check for facial nerve paralysis.
• 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 .

23. CONT..
• 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.
• Monitors for the return of bowel sounds, gag reflex
• Monitoring and managing potential complications.

24. COMPLICATIONS
• Lingering weakness, numbness, or other odd sensations even after
recovery
• Heart or blood pressure problems
• Pain
• Slow bowel or bladder function
• Blood clots and bedsores due to paralysis