Guillain-Barre Syndrome - Summary
Acute AIDP that presents ...
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Description

Guillain-Barre Syndrome - Summary
Acute AIDP that presents with rapidly progressive flaccid weakness
Epidemiology:
 - 1-2 cases/100,000 per year
 - Slightly greater in males than females
Pathophysiology:
 - Immune response preceding infections: Campylobacter jejuni, HIV, Influenza like illnesses, CMV, EBV, COVID 19, Zika virus, Vaccination (flu, meningococcal, H1N1)
Clinical Manifestations:
 - Fairly symmetric muscle weakness
 - Absent or depressed DTR's
 - Onset: Few days to a week
 - Weakness: mild difficulty with walking to nearly complete paralysis of all extremity, facial, respiratory and bulbar muscles
Miller Fisher Syndrome: Opthaloplegia, Ataxia, Areflexia
DIAGNOSIS:
 • CSF:
    - CSF PROTEIN
    - NORMAL CSF WBC (Albuminocytoligic dissociation)
 • Electrodiagnostic studies - EMG NCV can classify the main variants:
    (1) acute polyneuropathy with demyelination features
    (2) axonal form
 • MRI - Thickening and enhancement of intrathecal spinal nerve roots and cauda equina
 • GQ1b IgG Antibody associated with Miller Fisher Variant.
TREATMENT:
 - Plasmapharesis + IVIG
 - Mechanical ventilation
 - Steroids contraindicated-worse outcome

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Contributed by

Dr. Ravi Singh K
@rav7ks
Academic Hospitalist and APD @SinaiBmoreIMRes, Clinical reasoning,Simulation and POCUS enthusiast - https://twitter.com/rav7ks
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