BASIC INFO: Guillain-Barre Syndrome in Neuro Critical Care Unit

is each Acute Inflammatory Demyelinating Polyneuropathy (AIDP) 

There desire be diffuse weakness, areflexia and albuminocytologic separation. 

In ~60% there can have existence preceding upper respiratory infection or diarrhea through 30% of these cases attributed to Campylobacter jejuni  

Neurologic symptoms: insensibility, paraesthesias, dysesthesias and progressive, bilateral symmetric weakness that progresses by hours to days and peaks in a hardly any weeks. 

normal or hyperreflexia in the first phase changes to  areflexia. 

CSF : elevated protein destitute of pleocytosis (albuminocytologic dissociation is seen through only in 50% of patients for the time of their first week of illness and up to 75% ~ means of the third week)

Lumbar puncture is involuntary to rule out infectious diseases and malignancies. 

Medical complications : Respiratory failure and ~iness for mechanical ventilation, aspiration pneumonia, sepsis, arrhythmias, cardiac arrest, and dysautonomia. 

Screening on account of dysphagia and frequent bedside spirometry is necessity to prevent aspiration and further respiratory bring into danger. 

They often require narcotics, gabapentin or carbamazepine to manage their astute pain (A small portion of patients direction continue to experience radicular, arthralgia or meningitic misery up to one year later.) A dual come near of psychosocial support and SSRI therapy is recommended. 

both PLEX and IVIG are effective therapies since patients with GBS. 

Patients admitted in the reach two weeks of symptom onset, stratum bound on admission, and those that be obliged minimal comorbidities can be considered with regard to PLEX first. 

IVIG is may be easier to administer, especially when placement of a central de~ate is not readily available. 

A Cochrane regular review published in 2012 concluded that PLEX is to a greater degree effective than supportive care, IVIG may be slightly safer, and combination therapy was not besides effective than monotherapy 

Reference :

>Jacob S, Viegas S, Lashley D, Hilton-Jones D (2009) Myasthenia gravis and other neuromuscular junction disorders. Pract Neurol 9: 364-371. 

>Hughes RA, Swan AV, fore-rank Doorn PA (2012) Intravenous immunoglobulin in quest of Guillain-Barré syndrome. Cochrane Database Syst Rev. Wil ey Online Library 7.

>Bedside Critical Care Guide / Ramzy H Rimawi

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