Guillain-Barré syndrome is an autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It often follows a viral or bacterial infection. The body's immune system mistakenly attacks and destroys the myelin sheath surrounding nerves. This damages nerve impulses and causes muscle weakness. Symptoms include progressive muscle weakness, numbness, pain, and difficulty walking or breathing. It can range from mild to life-threatening. The cause is unknown but molecular mimicry between infectious agents and nerve tissues may play a role.

1. GUILLAIN BARRE SYNDROME
NO. Group members
1. AINULASRAH BINTI ZAINUDDIN
2. MOHAMMAD FAZLI BIN NORMAN
3. NOR IZZATIE BINTI HAMDAN
4. NURFARAHIN BINTI MOHAMAD FARZEE
5. SITI NOR SYAFAWANI BINTI MOHAMAD SYAH

2. Introduction
 Guillain-Barre syndrome is a disorder that causes
damage to the peripheral nerves. The nerve injury often
causes muscle weakness, often does cause paralysis
and sensitivity problems, including pain, tingling, “pins
and needles in the skin” or some numbness.
 Guillain-Barre syndrome is an autoimmune disorder in
which the body’s immune system attacks and destroys
the myelin sheath that surrounds nerve cells of the large
body, like an insulator covering a water pipe. If myelin is
destroyed, nerve impulses traveling very slowly and can
be interrupted. If the muscles are not properly stimulated
through the nerves will not function correctly.

3. ETIOLOGY

5. Etiology
 No one yet knows why Guillain-Barré
 There are varying degrees of severity
 Onset usually occurs 1-3 weeks after exposure to a viral
infection
 Destruction most often occurs in segments between the
Nodes of Ranvier
 Body's immune system begins to attack the body itself
(autoimmune disease)
 When the GBS is preceded by a viral infection, there is no
evidence of direct viral infection of peripheral nerves or
nerve roots.
 Usually Guillain-Barré occurs a few days or weeks after the
patient has had symptoms of a respiratory or
gastrointestinal viral infection.
 surgery will trigger the syndrome
 vaccinations may increase the risk of GBS

7. Pathophysiology of Gullian-Barre
Syndrome

8. Contaminated
food or water
Pathogen (C.jejuni)
+
Immature antigen
presenting cell
Innate immune response
MHC (Mature, differentiated antigen
presenting cell) migrates to lymph nodes.
Activate CD4T cells, in the same time
activate B cells
Cell mediated + humoral immunity
response
Pathogen & host have
identical amino acid
sequences, antigens in its
capsule are shared w/
nerves

9. Antibodies produce
Activation of the
complement system &
phagocytosis of bacteria
Molecular mimicry
Antibodies that produced cross react with myelin,
Lymphocytes and macrophages circulate in blood
& find myelin.
Lymphocytic infiltration of spinal roots &
peripheral nerves.
Macrophage – mediated , multifocal stripping of
myelin & axonal damage.
Defects the propagation of electrical nerve
impulses, w/ eventual conduction block
Guillian – Barre Syndrome (GBS

10. Sign of Gullain-Barre Syndrome

11. Cardinal Features of GBS
 Progressive weakness of two or more limb (Unterman,
Chapman & Shoenfeld, 2012), sometimes can have
difficulty in walking (Seneviratne, 2000)
 Fairly symmetric muscle weakness on both proximal
and distal (Winer, 2008)
 Hypotonia (Frontera, 2009) & muscle wasting
(Seneviratne, 2000)
 Facial, respiratory, and bulbar muscles weakness.
(Seneviratne, 2000)

12.  Miller Fisher syndrome (Fisher, 1956), described
with ataxia, areflexia (Unterman, Chapman &
Shoenfeld, 2012) & ophtalmoplegia, mild limb
weakness, ptosis, facial & bulbar palsy.
(Seneviratne, 2000)
 Exaggerated DTR, in ACUTE PHASE: hyperreflexia
(Seneviratne, 2000)
 AMAN: with retained or brisk reflexes (Winer, 2008)
 Preservation of cutaneous relfexes (Bounduelie,
1998)

13.  Respiratory muscles weakness followed by
ophtalmoplegia & tongue weakness (Seneviratne,
2000) presence with clear dyspnoea, failing resp.
effort d/t falling VC (Winer, 2008)
 Bulbar weakness predisposing to pulmonary
aspiration requiring tracheal intubation for airway
protection (Gupta & Summors, 2001)
Respiratory sign

14. Neurological Features
 Cranial Nerve deficit (Franz, 2000) in (III- VII, IX- XII)
with facial palsy (Seneviratne, 2000)
 Ptosis, opthalmoparesis (diplopia), facial weakness,
dysarthria, dysphagia with pooling of secretions.
 Sensory dysfunction (Seneviratne, 2000) with
abnormal proprioception, sensory ataxia can also
occur (Frontera, 2009)
 Gloves and stocking paraesthesias (Gupta &
Summors, 2001) with slight disturbances of
sensibility (Bounduelie, 1998)

15. Type of GBS Characteristics
Acute inflammatory
demylinating
polyradiculoneurpathy (AIDP)
• Primary demylinating
• Progressive, symmetric weakness,
absent or depressed DTR.
Acute sensorimotor axonal
neuropathy (ASMAN)
Up to 1/3 may be hyperreflexic
Miller Fisher Syndrome • Triad of ataxia, ophtalmoplegia, and
areflexia.
• 1/3 develop extremity weakness
Acute Pandysautonomia • Symphatetic and parasymphatetic
involvement.
•Orthostatic hypotension
•Urinary retention
•Diarrhea, abdominal pain, ileus, vomitting
•Pupillary abnormalities
•Reflexed diminished
•Decreased sweating, salivation &
lacrimation (Gupta & Summors, 2001)

16. SYMPTOMS
OF GULLIAN-BARRE SYNDROME

17.  Muscle weakness (both side of the body). (Jewett,2010).
 Weakness spreads to the arms and upper body. The
weakness may increase until muscles cannot be used at all
and may result in paralysis.
 Muscle ache, pains or cramps.
 Occurred at the large muscles, such as the thighs, lower
back, buttocks and shoulders as earliest symptom.
 Experiences loss or reduction of the sense of touch, or
abnormal sensations.
 Inability to walk due to muscle weakness and paralysis.
(Daniel & Green, 2011).

18.  Difficult to speaking, chewing and swallowing.
(Healthwise, 2010).
 various muscles required to form speech are weakened.
 Breathing difficulties.
 Blurred vision.
 Dizziness, migraines, pain in the back of head.
(Hassan,2010).
 Pain in bladder area due to bladder dysfunction.
(Hassan,2010).

19.  Among the first symptoms are pain, numbness,
paraesthesia, or weakness in the limbs. ( Doorn,
Ruts, Jacobs, 2008 ).
 GBS is an autoimmune acute peripheral neuropathy
that cause limb weakness that progresses over a
period of days and up to 4 weeks. (Unterman,
Chapman, Shoenfeld, 2012).

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