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58 Cards in this Set
- Front
- Back
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what is guillian barre syndrome
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autoimmune disorder of the peripheral nervous system causing progressive weakness of the limbs with diminished/absent DTRs
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GBS is an inflammatory process that affects ____
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schwann cells
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what happens to the schwan cells resulting in the conduction block
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macrophages attack them, rapidly demyelinating the axon but leaving it intact
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what might cause secondary axonal damage in GBS
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lymphocytic infiltration-- wallerian degeneration of the distant axon
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how common is GBS
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most common cause of nontraumatic paralysis in US
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what is the incidence of GBS
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1: 100,000
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what is the age for GBS
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any
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what is the sex for GBS
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either
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race for GBS
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any
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what is the etiology for GBS
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exact cause remains unknown
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what are the precipitating factors for GBS
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1) recent respiratory or GI infection (10-14 days prior)
2) surgery or epidural analgesia 3) vaccination within previous 8 weeks |
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_________ has been implicated in more severe cases of GBS
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campylobacter jejune virus
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GBS has a positive association with
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other autoimmune diseases
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_____% will fully recover from GBS
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65-75%
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____% will die from GBS
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2%
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______% will have moderate residual weakness from GBS
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10
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______ % will have severe lasting disability
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15%
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what is the recovery pattern for GBS
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avg. 3-8 months of gradual improvement, with more severe cases taking >1 year
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what must occur for GBS recovery
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axonal growth and remyelination
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what is the rate for axonal growth/remyelination
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1 mm/day
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what are the precipitating factors for GBS
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1) recent respiratory or GI infection (10-14 days prior)
2) surgery or epidural analgesia 3) vaccination within previous 8 weeks |
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_________ has been implicated in more severe cases of GBS
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campylobacter jejune virus
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GBS has a positive association with
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other autoimmune diseases
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_____% will fully recover from GBS
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65-75%
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____% will die from GBS
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2%
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______% will have moderate residual weakness from GBS
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10
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______ % will have severe lasting disability
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15%
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what is the recovery pattern for GBS
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avg. 3-8 months of gradual improvement, with more severe cases taking >1 year
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what must occur for GBS recovery
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axonal growth and remyelination
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what is the rate for axonal growth/remyelination
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1 mm/day
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what are the precipitating factors for GBS
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1) recent respiratory or GI infection (10-14 days prior)
2) surgery or epidural analgesia 3) vaccination within previous 8 weeks |
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_________ has been implicated in more severe cases of GBS
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campylobacter jejune virus
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GBS has a positive association with
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other autoimmune diseases
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_____% will fully recover from GBS
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65-75%
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____% will die from GBS
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2%
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______% will have moderate residual weakness from GBS
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10
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______ % will have severe lasting disability
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15%
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what is the recovery pattern for GBS
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avg. 3-8 months of gradual improvement, with more severe cases taking >1 year
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what must occur for GBS recovery
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axonal growth and remyelination
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what is the rate for axonal growth/remyelination
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1 mm/day
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what is the chronic form of GBS
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chronic inflammatory demyelinating polyneuropathy
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what is chronic inflammatory demyelinating polyneuropathy
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>6 months of symptoms or recurrence of the symptoms
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_____% of GBS pts. have been preceeded by
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infection (upper res, GI)
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CSF shows ___________ for GBS
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elevated protein, few WBC
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what happens to NCV with GBS
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slowed
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what must be ruled out for GBS
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- acute spinal cord lesion
- MS - polio - myasthenia gravis - toxic - metabolic - infection |
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what is the onset for GBS
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rapid onet of weakness
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in GBS weakness is often severe, progressint to its max in
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1-3 weeks
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what is the pattern of paresis in GBS
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distal LE paresis progresses proximally, including facial muscles in 2-5 days
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pts. with GBS can become ____, _____, and have _____
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quadriparetic, ventilator dependent, and have autonomic involvement
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how is GBS distributed
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relatively symmetrical
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what are the reflexes like for GBS
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areflexic/hyporeflexis
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what are the sensory disturbances for GBS
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mild disturbances, especially in feet
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_____ findings are rare with GBS
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eye
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what is the medical management for GBS
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- corticosteroids
- plasmaphoresis - immunosuppressive therapy (IVIG) - respiratory support (trach, vent) |
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what is plasmaphoresis
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taking out a person's blood, freeze it and take out the antibodies---> basically filter out the plasma
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what is immunosuppressive therapy for guillan barre syndrome
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give immunoglobulin - someone elses healthy immune cells and put them in so they will stop attacking their own system
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why is respiratory support used for pts. with guillan -barre syndrome
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more for support- to treat symptoms... not the underyling problem
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