here's my notes from class:
StartFragment
Guillain Barre: acute idiopathic inflammatory
demyelinating polyneuropathy
sensory disturbance (tingling)
progressive muscle weakness and
areflexia (rubbery legs)
associated with spontaneous
remission
annual incidence of 0.6 -2.4
cases per 100,000 population
occurs at all ages and both
sexes
most common cause of acute
flaccid paralysis in healthy people
a heterogeneous syndrome with
several variant forms
Associated conditions
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Antecedent respiratory tract or
gastrointestinal infection
EBV, CMV, HSV, Lyme, H. flu,
campylobacter jejuni
Post vaccine
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Swine influenza vaccine 1976
13
days post Rx
Clinical features
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Sx develop 1-3 weeks post infection
Fine paresthesias of toes and
fingertips
Symmetrical lower extremity weakness
(progressive)
Weakness ascends to arms, cranial
nerves (7)
Facial
diparesis
Respiratory muscles may be involved
Sciatic pain may be present
30% require mechanical ventilation
mild
form: upper ext weakness,
areflexive, gait difficulty
mod form: unable to walk alone
severe form: ascending paralysis, may require vent
Physical exam
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Symmetrical weakness with diminished
or absent reflexes
Orthostatic hypotension
Paralytic ileus
Bladder dysfunction
Abnormal sweating
Diagnosis
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NCS are slowed
Partial motor conduction block
Helps to prognosticate
CSF shows increased protein and normal
wbc = albuminocytologic dissociation
Antibodies may be present dependent on
variant
Management
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20/30/40 rule
Vital capacity of