This presentation provides information on Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). It discusses their etiology, clinical presentation, diagnosis, and physiotherapy management. Both GBS and CIDP result from an autoimmune attack on peripheral nerves causing demyelination. While GBS is acute, CIDP is chronic with progressive symptoms over time. Clinical features include weakness, numbness, and sensory loss. Physiotherapy focuses on maintaining function, mobility, and recovery through various exercises depending on the patient's stage of illness. Prognosis is generally good, with around 65% of GBS patients achieving near complete recovery within a year.
This presentation consist information about unspoken and less well known variants of GBS as well as CIDP. Also it includes information about diagnosis and management.
This presentation consist information about unspoken and less well known variants of GBS as well as CIDP. Also it includes information about diagnosis and management.
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
INTRODUCTION OF GBS,
TYPES OF GBS,
INCUDENCE OF GBS,
ETIOLOGY OF GBS,
PATHOLOGY OF OF GBS,
CLINICAL FEATURES OF GBS,
INVESTIGATION OF GBS,
DIAGNOSTIC CRITERIA OF GBS,
PROGNOSIS OF GBS,
TRATMENT OF GBS,
PHYSIOTHERAPY MANAGEMENT IN CASE OF OF GBS,
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
INTRODUCTION OF GBS,
TYPES OF GBS,
INCUDENCE OF GBS,
ETIOLOGY OF GBS,
PATHOLOGY OF OF GBS,
CLINICAL FEATURES OF GBS,
INVESTIGATION OF GBS,
DIAGNOSTIC CRITERIA OF GBS,
PROGNOSIS OF GBS,
TRATMENT OF GBS,
PHYSIOTHERAPY MANAGEMENT IN CASE OF OF GBS,
presentation for gullian pary syndrome.pptxSondosHawari2
Guillain-Barré syndrome (GBS) :
Popularly known as “French polio” is an acute inflammatory demyelinating polyneuropathy marked by inflammation of the peripheral nerves, that affecting arms and legs.
characterized by progressive muscle weakness and areflexia, and disrupted proprioception .
In Guillain-Barré syndrome, the myelin sheath surrounding the axon is lost makes nerve impulse transmission is aborted.
All forms of Guillain–Barré syndrome are autoimmune disease, due to an immune response to foreign antigens
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
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Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
3. Presented by..
Abid Hasan Khan
B.Sc. In Physiotherapy
Roll : 30
Session : 2015-16
Bangladesh Health Professions Institute (BHPI),
CRP-Savar, Dhaka.
3
5. Contents
Introduction
GBS & CIDP
Epidemiology
Etiology
Is CIDP as same as Guillain-Barre syndrome?
Clinical presentation
Diagnosis
Physiotherapy Management
Prognosis
References
5
6. Introduction
Guillain-Barre syndrome (GBS) is an acute inflammatory disease of
the peripheral nerves. An autoimmune attack on the myelin results in
demyelination. Loss of myelin can occur in sensory, motor or
autonomic nerves. A chronic form of this illness may present with
progressive symptoms and result in CIDP (Chronic inflammatory
demyelinating polyneuropathy).
(Ruts et al., 2010)
6
8. GBS & CIDP
Guillain Barre syndrome (GBS) may defined as post
infectious polyneuropathy occurs due to demyelination of
mostly motor neuron but sometimes sensory and autonomy
neurons. It is also known as Acute inflammatory
demyelinating polyneuropathy.
(Van Doorn et al., 2008)
8
9. Continues..
On the other hand,
Chronic inflammatory demyelinating polyneuropathy
(CIDP) is the most common chronic autoimmune
neuropathy. This condition is treatable for relatively long
periods of time (months to years) in the majority of patients.
(Dalakas, 2011)
9
10. Epidemiology
It has been reported that 16% of patients with CIDP have rapidly
progressive weakness within 8 weeks from onset of disease,
which is followed by a chronic course. These patients are
considered to have acute-onset CIDP (A-CIDP). On the other
hand, 8%–16% of patients with GBS have one or more
deteriorations shortly after initial improvement or stabilization
following plasma exchange or IV immunoglobulin (IVIg),
described as treatment-related fluctuations (TRF).
(Ruts et al., 2010)
10
11. Etiology
For both of the diseases, the cause is mainly unknown.
An autoimmune process is presumed to be triggered by
various agents -
• Bacteria :
- Campylobacter Jejuni.
- Mycopalsma Pneumonia.
11
12. Continues..
• Viruses :
- Cytomegalo virus (CMV)
- Epstein-Barr Virus (EBV)
- Human Immunodeficiency Virus (HIV)
12
13. Is CIDP as same as Guillain-Barre
syndrome?
Chronic inflammatory demyelinating polyneuropathy (CIDP) is closely
related to Guillain-Barre syndrome (GBS). Both are nerve problems,
and both cause symptoms such as weakness and numbness. But GBS
usually comes on days or weeks after a person has an illness. CIDP
isn’t linked to illness. With GBS, once treated, most people recover
fairly quickly. CIDP, on the other hand, tends to be a longer-term
problem. In rare cases, people who don’t recover from GBS may
develop CIDP.
(Ruts et al., 2010)
13
14. Clinical Presentation
Both CIDP & GBS arises between the ages of 30 and 60
years and is characterized by a progressive, symmetric,
proximal and distal muscle weakness, paresthesia, sensory
dysfunction, and impaired balance.
a) Paresthesia & numbness are frequent & early symptoms
which usually begin at toe.
(Ruts et al., 2010)
14
15. Continues…
b) Muscle weakness: Symmetrical muscle weakness usually
starts at lower limb involving the proximal muscles greater
than the distal. Weakness first noted as difficulty in walking.
It ascends progressive towards trunk musculature & arm
muscles.
15
16. Continues…
c) Lower motor neuron type paralysis: The weakness can
progress to total motor paralysis. It is flaccid type &
ascending type in nature.
d) Respiratory complication: Weakness of respiratory
muscle may also occur & sometimes leads to respiratory
failure. Patient with partial respiratory failure complains of
unable to speak a complete phrase within one breath.
16
17. Continues…
e) Sensory loss: Sometimes deep sensations i.e. touch,
pressure, vibration tends to be more affected than the
superficial pain, temperature and tingling sensation.
f) Pain: 50% patients experience pain which generally
maximal in the back, shoulder & buttocks.
17
19. Diagnosis
A detailed History.
Symptoms & sign.
Investigation :
- CSF study shows a very high protein with no or few
lymphocytes.
- EMG & nerve conduction studies (NCV) may confirm a
demyelinating neuropathy.
- Cerebrospinal fluid analysis and nerve biopsy
(Köller et al., 2011 & Van Doorn et al., 2008)
19
20. Physiotherapy management
Physiotherapy management can be divided into two stages &
it depends widely on patient’s physical status - Respiratory
status, Muscles power, Joint ROM & psychological make up
of patient’s :
1) Acute progressive stage.
2) Recovery stage.
20
21. Acute progressive stage
In this stage, patient is under intensive care unit & the aim of
physiotherapy are –
Maintain clear airway
Prevent lung infection
Maintain joint ROM
Support joints in a functional position to prevent
deformity
21
22. Continues..
Assist in prevention of pressure sore
Maintain peripheral circulation
Reduce joint pain
Maintain muscle power
Provide psychological support to the patient (if conscious) &
relatives.
22
23. Continues..
a) Maintenance of clear airways :
• Proper positioning.
• Breathing will be assisted by intermittent positive pressure
ventilation (IPPV)
• Assisted coughing.
• Manual techniques used to assist in maintaining &
clearing the airways - Vibration, Shaking & clapping.
23
28. Continues…
d) Prevention of pressure sore :
• Care & checking the skin regularly.
• Position should be changed for every two hourly.
e) Maintenance of circulation :
• Passive movements.
• Gentle but firm massage.
28
31. Recovery stage
When the patient can maintain his own airway & ventilation
& some motor recovery is occurring, an assessment of the
patient’s problem is required to define treatment priorities :
a) Respiratory system :
• Rate, depth & pattern of breathing should noted &
maintenance of airway & ventilation capacity by BCE,
DBE & ACBT.
31
32. Continues…
b) To reduce pain :
• Gentle active assisted movement within pain free range.
• Mobilization of the joints.
c) To improve & support normal joint ROM :
• Active assisted movement.
• Splints.
• Pulley & cycling (depends on patient ability).
32
35. Continues…
d) To improve muscle power :
• Strengthening exercise by using suspension therapy.
• Isotonic exercise by using variable weight.
• Progressive resistance exercise by using Thera band.
• PNF techniques.
• Hydrotherapy.
35
40. Continues…
e) To improve functional ability :
• Side change from supine to side lying & side lying to
prone lying.
• Bridging practice.
• Back strengthening exercise practice.
• Supine to sitting practice.
40
43. Continues…
f) To improve balance & coordination :
• Sitting over the edge of bed & support the proximal key &
moving the distal key points.
• Sitting on a gymnastic ball & rock it forward, backward &
sideways.
• Practice finger to nose & heel to shin coordination
exercise (when patient can perform AROM)
43
44. Continues…
• Standing practice with the support of standing frame.
• Sit to stand practice with use of standing frame.
• Standing balance practice with open eyes & close eyes.
• Ball throw practice in standing.
44
47. Continues…
g) To re-educate normal gait pattern :
• Before re-education of gait pattern an assessment of hip,
knee, ankle motion should be done .An orthotic device eg.
Toe pick up splint can be given in order to increase the
ankle dorsiflexion during swing phase of gait cycle.
47
48. Continues…
• Walking practice in parallel bar.
• Walking practice with walking frame.
• Walking practice in even surface, rough surface & in
straight line.
• Stairing practice-ascending & descending.
48
52. Continues…
h) Motivation :
• Ensuring the patient about the recovery.
• Motivation & general psychological approach to life in
general.
52
53. Prognosis
Recent trial data show that 30–40% of patients with CIDP are
either ‘cured’ or in ‘chronic remission’. Although these figures
are rewarding to both physicians and patients. And studies of
outcome in GBS suggest that at the end of one year from onset of
the neuropathy 65% of patients achieve an almost complete cure
so that they regain the ability to perform manual work. Of the
35% who do not, about 8% will die in the acute stage usually
from cardiac arrhythmias or pulmonary emboli.
(Dalakas, 2011 & Winer, 2001)
53
54. References
Ruts, L., Drenthen, J., Jacobs, B.C. and Van Doorn, P.A., (2010). Distinguishing
acute-onset CIDP from fluctuating Guillain-Barre syndrome: a prospective study.
Neurology, 74(21), pp.1680-1686.
Dalakas, M.C., (2011). Advances in the diagnosis, pathogenesis and treatment of
CIDP. Nature Reviews Neurology, 7(9), p.507.
van Doorn, P.A., Ruts, L. and Jacobs, B.C., (2008). Clinical features,
pathogenesis, and treatment of Guillain-Barré syndrome. The Lancet Neurology,
7(10), pp.939-950.
Köller, H., Kieseier, B.C., Jander, S. and Hartung, H.P., (2005). Chronic
inflammatory demyelinating polyneuropathy. New England Journal of Medicine,
352(13), pp.1343-1356.
Winer, J.B., (2001). Guillain Barre syndrome. Molecular Pathology, 54(6), p.381.
54