Guillain barre syndrome


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Guillain barre syndrome

  1. 1. GBS : Guillain-Barré syndrome 1 SUHAS PAI 09-07-2012
  2. 2. GBS is also known as:• Acute idiopathic polyradiculoneuritis• Acute idiopathic polyneuritis• French polio• Landrys ascending paralysis• Landry guillain barré syndrome. 2 SUHAS PAI 09-07-2012
  3. 3. CLASSIFICATIONSix different subtypes of GBS: 3 SUHAS PAI 09-07-2012
  4. 4. • Acute inflammatory demyelinatingpolyneuropathy (AIDP) is the mostcommon form of GBS, and the term isoften used synonymously with GBS.• It is caused by an auto-immune response directed against Schwann cell membranes. 4 SUHAS PAI 09-07-2012
  5. 5. • Miller Fisher syndrome (MFS) is a rare variant of GBS.• Accounting for approximately 5% of GBS cases, it manifests as a descending paralysis, proceeding in the reverse order of the more common form of GBS.• It usually affects the eye muscles first and presents with the triad of ophthalmoplegia,ataxia, and areflexia.• The ataxia predominantly affects the gait and 5 trunk, with the limbs relatively spared. SUHAS PAI 09-07-2012
  6. 6. • Acute motor axonal neuropathy (AMAN), also known as Chinese paralytic syndrome, attacks motor nodes of Ranvier and is prevalent in China and Mexico.• It is probably due to an auto-immune response directed against the axoplasm of peripheral nerves.• The disease may be seasonal and recovery can be rapid. 6 SUHAS PAI 09-07-2012
  7. 7. • Acute motor sensory axonal neuropathy(AMSAN) is similar to AMAN but alsoaffects sensory nerves with severe axonaldamage.• Like AMAN, it is probably due to an auto-immune response directed against the axoplasm of peripheral nerves.• Recovery is slow and often incomplete. 7 SUHAS PAI 09-07-2012
  8. 8. • Acute panautonomic neuropathy is the most rare variant of GBS, sometimes accompanied by encephalopathy.• It is associated with a high mortality rate, owing to cardiovascular involvement, and associated dysrhythmias. 8 SUHAS PAI 09-07-2012
  9. 9. • Bickerstaffs brainstem encephalitis (BBE) is a further variant of Guillain–Barré syndrome.• It is characterized by acute onset of ophthalmoplegia, ataxia, disturbance of consciousness, hyperreflexia or Babinskis sign. 9 SUHAS PAI 09-07-2012
  10. 10. 10SUHAS PAI 09-07-2012
  11. 11. FACTS• Guillain-Barré syndrome occurs when the immune system attacks the peripheral nervous system• leading to weakness or tingling in the legs. Symptoms sometimes affect the arms and upper body.• Severe cases of Guillain-Barré can lead to paralysis and are life-threatening. 11 SUHAS PAI 09-07-2012
  12. 12. • Guillain-Barré is a very rare condition• afflicts about one person out of 100,000.• The condition often manifests after a respiratory or gastrointestinal viral infection.• Surgery or vaccines may also trigger GBS. 12 SUHAS PAI 09-07-2012
  13. 13. • The autoimmune reaction in Guillain-Barré is directed against the myelinsheaths that surround the axons ofperipheral nerves or the axons (parts of thenerve) themselves.• The greatest point of weakness orparalysis can occur in days or weeks afterthe first symptoms occur. 13 SUHAS PAI 09-07-2012
  14. 14. • Because the signs and symptoms of GBS vary, it can be difficult to diagnose the condition in the early stages.• A physical exam as well as an examination of the cerebrospinal fluid (CSF) obtained from a spinal tap may help aid diagnosis. 14 SUHAS PAI 09-07-2012
  15. 15. • Treatment of Guillain-Barré syndrome may include • plasma exchange (plasmapheresis) • high-dose immunoglobulin therapy.• A respirator may be used if the patient requires assistance to breathe.• Physical therapy can begin after the patient recovers limb control. 15 SUHAS PAI 09-07-2012
  16. 16. • The recovery period after about of Guillain-Barré may be as little as a few weeks or as long as a few years.• About 30% of those with Guillain-Barré may suffer from residual weakness after 3 years.• Ongoing research seeks to identify the cause of Guillain-Barré and develop new and better treatments. 16 SUHAS PAI 09-07-2012
  17. 17. What is GBS?• Bodys immune system attacks part of the peripheral nervous system.• Can affect anybody, can strike at any age and both sexes• Rare : afflicts 1 or 2 in 100,000 17 SUHAS PAI 09-07-2012
  18. 18. • Usually occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral or bacterial infection.• First symptoms • varying degrees of weakness in legs • tingling sensations in the legs• Weakness and abnormal sensations spread to the arms and upper body. 18 SUHAS PAI 09-07-2012
  19. 19. • Severe: Muscle Wasting, Paralysis.• Life threatening - potentially interfering with breathing and with blood pressure or heart rate.• Most patients recover from even the most severe cases of GBS, although some continue to have a certain degree of weakness. 19 SUHAS PAI 09-07-2012
  20. 20. CAUSES• Not yet exactly known.• Bodys immune system begins to attack the body itself• Destroy the myelin sheath that surrounds the axons of many peripheral nerves, or even the axons themselves 20 SUHAS PAI 09-07-2012
  21. 21. • Peripheral nerve’s myelin sheaths are injured or degraded, the nerves cannot transmit signals efficiently• Motor and sensory response becomes weak.• Signals to and from the arms and legs must travel the longest distances : most vulnerable to interruption• So muscle weakness and tingling sensations first appear in the hands and feet and progress upwards 21 SUHAS PAI 09-07-2012
  22. 22. • GBS is preceded by a viral or bacterial infection• It is possible that the virus has changed the nature of cells in the nervous system so that the immune system treats them as foreign cells• Virus makes the immune system itself less discriminating about what cells it recognizes as its own 22 SUHAS PAI 09-07-2012
  23. 23. • Symptoms can progress over the course of hours, days, or weeks.• Most people reach the stage of greatest weakness within the first 2 weeks after symptoms appear• By the third week of the illness, 90 percent of all patients are at their weakest.• Cause and course of GBS is an active area of neurological investigation 23 SUHAS PAI 09-07-2012
  24. 24. DIAGNOSIS• Reflexes such as knee jerks are usually lost.• As the signals traveling along the nerve are slower, a nerve conduction velocity (NCV) test aids in diagnosis.• The CSF contains more protein than usual. (spinal tap test, a procedure in which needle is inserted into the patients lower back to draw csf from the spinal 24 column) SUHAS PAI 09-07-2012
  25. 25. TREATMENT• No known cure• Plasmapheresis (Exchange of Plasma)• High-dose immunoglobulin therapy.• Both reduce the severity and duration of the Guillain-Barré episode. 25 SUHAS PAI 09-07-2012
  26. 26. 26SUHAS PAI 09-07-2012