The document summarizes Guillain-Barré syndrome (GBS), an autoimmune disorder where the body's immune system attacks the peripheral nervous system. GBS is characterized by weakness and tingling in the extremities and can cause paralysis. It is treated with intravenous immunoglobulin or plasmapheresis to prevent further damage by antibodies. Most patients recover fully, though recovery may take months or years with physical therapy.

1. COMPILED BY
Nazar deen FAROOQI
IPM&R,DUHS

2.  Landrys ascending paralysis.
 Acute inflammatory demyleniating poly
neuropathy (AIDP)
 Acute idiopathic polyneuritis
 French polio
 Landry Guillain Barre syndrome.

3.  GBS is an autoimmune disease marked by an acute inflammation
of the peripheral nerves effecting arms and legs.
 It is characterized by weakness and numbness or tingling in legs,
arms, and possible loss of movement in upper body and face.
 Involves destruction of myelin sheath surrounding largest most
myelinated sensory motor fiber.
 Resulted in disruption of proprioception and weakness of limbs.
 In more severe cases complete paralysis and breathing difficulty
noted.
 In most cases GBS follows recent viral and bacterial infections.

4.  No clear cause.
 Neither contagious nor hereditary.
 Possible vaccine causal link.
 Autoimmune----body produces antibodies that
damages myelin sheath.
 In about half of all cases the onset of symdrom follows
viral or bacterial infections.
 Camphylobacteriosis---usually eating uncooked
poultry.
 Influenza
 Gastrointestinal viral infection.
 HIV

5. •Porphyrin----rare disease of RBC.
•Viral hepatitis.
• Epidural anesthesia.
•Thrombolytic agents.
•Small number of cases have been known to occur after minor surgeries
• GBS has been associated with systemic processes like
•Hodgkin’s disease.
•SLE
•Sarcoidosis
•EBV, CMV,
•Lyme disease.
•Mycoplasma.

6.  Hypotonia and areflexia (absence of reflexes).
 Numbness and tingling in hands and feet Distal
progression:
 Muscle weakness
 Diminished reflexes and proprioception,
decreased sensation,
 For some progresses to trunk, face, and cranial
nerves, resulting in difficulty swallowing,
chewing, speaking, and facial expressions
 Deep, aching pain/hypersensitivity to touch
 Respiratory/cardiac dysfunction and failure.

7. •The initial symptoms are SENSORY CHANGES: paresthesia,
numbness; usually mild; 70% pts have sensory abnormalities.
•burning,tingling,shocklike,persistent in 5-10%
•WEAKNESS- ascending and symmetrical, lower limbs
involved first, proximal muscles involved earlier; develops
acutely and progresses; wide variations in severity.
•AUTONOMIC CHANGES: tachycardia, bradycardia, facial
flushing, paroxysmal HTN, orthostatic hypotension,
anhidrosis,diaphoresis, urinary retention, ileus, dizziness;
more common if severe weakness or respiratory failure.

8.  It is characterized by focal segmental
demyelination with perivascular and endoneurial
infiltrates of lymphocytes and monocytes or
macrophages.
 These lesions are scattered throughout the
nerves, nerve roots. And cranial nerves.
 In particularly severe lesions, there is both
axonal degeneration and segmental
demyelination
 During recovery, remyelination occurs, but the
lymphocytic infiltrates may persist.

9.  Affects 2/100000 annually.
 None-discriminatory, can effects persons of
any gender, age.

10.  80% experience complete recovery.
 Recovery may last for 2 months to 2 years, It has three distinct
phases.
 Acute (4 weeks) initial rapid onset of symptoms.
 Plateau (few days to few weeks). Symptoms neither worsen nor
improve.
 Recovery (gradual improvement or recovery is accompanied by
pain and tingling in limbs.
 Childrens makes better recovery than adults.
 Recent studies on the disease demonstrate that approximately
80% patients have Myelin loss while 20% have Axon loss.
 5% dies because of cardiopulmonary complications.

11.  GBS is difficult to diagnose because of
symptoms varying and due to no specific
cause.
 Physical and neurological examination.
 Lumber puncture (high protein contents is
demonstrated in CSF).
 NCS (showing flowing o nerve conduction in
nerves root and in peripheral nerves
 EMG (Ineffective tool)

12.  Limited physical mobility.
 Inability to engage in meaningful occupation
because of pain.
 Extreme muscle weakness in arms and legs.
 Fatigue.
 Sensory functions impaired.
 Mental confusion.

13.  Medical
 GBS should be considered as medical
emergency.
 Intravenous immunoglobulin therapy.
 It prevents immune system from further
attacking Schwann cells and myelin sheath,
brocking receptor and microphage
 Plasmapheresis
 Filters blood plasma to remove antibodies. It can
shorten the course, alleviates symptoms in
prevent paralysis.

14. •Corticosteroids
•It inhibit inflammation associated with symptoms.
• Muscle relaxant/ anticonvulsant / pain killer.

15.  Before recovery begins (PROM)
 After symptoms subside (ARON)
 Positioning .
 Active muscle strengthening.
 Mobility skills. Training with adaptive devices
such as wheel chairs or braces.
 Hydrotherapy. Whirlpool hydrotherapy may
release pain and useful in retraining the
movements of effected limbs.
 Counseling. To feel positive about their disease.