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    GBS

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    Rahma Arsella
    Guillain-Barré Syndrome (GBS) is an acute autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It typically occurs 1-3 weeks after a viral or bacterial infection. The body mistakes parts of the nerves as foreign and attacks them. Symptoms include tingling, weakness in the legs and arms, and possible paralysis that moves upwards. There is no cure, but treatments such as plasmapheresis or immunoglobulins can reduce symptoms and limit paralysis. Most patients recover fully, though it may take months to a year, and a small percentage may experience a relapse.

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    GBS

    Uploaded by

    Rahma Arsella
    87 views19 pages
    Guillain-Barré Syndrome (GBS) is an acute autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It typically occurs 1-3 weeks after a viral or bacterial infection. The body mistakes parts of the nerves as foreign and attacks them. Symptoms include tingling, weakness in the legs and arms, and possible paralysis that moves upwards. There is no cure, but treatments such as plasmapheresis or immunoglobulins can reduce symptoms and limit paralysis. Most patients recover fully, though it may take months to a year, and a small percentage may experience a relapse.

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    Guillain-Barré Syndrome (GBS) is an acute autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It typically occurs 1-3 weeks after a viral or bacterial infection. The body mistakes parts of the nerves as foreign and attacks them. Symptoms include tingling, weakness in the legs and arms, and possible paralysis that moves upwards. There is no cure, but treatments such as plasmapheresis or immunoglobulins can reduce symptoms and limit paralysis. Most patients recover fully, though it may take months to a year, and a small percentage may experience a relapse.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    87 views19 pages

    GBS

    Uploaded by

    Rahma Arsella
    Guillain-Barré Syndrome (GBS) is an acute autoimmune disorder where the immune system attacks the peripheral nervous system, causing muscle weakness and possible paralysis. It typically occurs 1-3 weeks after a viral or bacterial infection. The body mistakes parts of the nerves as foreign and attacks them. Symptoms include tingling, weakness in the legs and arms, and possible paralysis that moves upwards. There is no cure, but treatments such as plasmapheresis or immunoglobulins can reduce symptoms and limit paralysis. Most patients recover fully, though it may take months to a year, and a small percentage may experience a relapse.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 19

    Guillain-Barr Syndrome

    Dr. Maula N Gaharu, Sp.S

    Guillain-Barre Syndrome (GBS)


    Suatu polineuropati yang bersifat ascending

    dan akut yang sering terjadi setelah 1 sampai


    3 minggu setelah infeksi akut.
    Autoimmune
    Occurs year round
    3500 cases per year in US and Canada
    Males are 1.5x than females
    Adults > Children

    Pathogenesis
    Acute autoimmune

    disorder
    There is involvement
    of T lymphocytes and
    B lymphocytes
    Brain is unable to send
    messages
    Legs and arms are
    commonly affected

    Etiology

    There are varying


    degrees of severity
    Onset usually occurs
    1-3 weeks after
    exposure to a viral
    infection
    Destruction most often
    occurs in segments
    between the Nodes of
    Ranvier

    Etiology

    Clinical Manifestations
    Signs and Symptoms Include
    Paresthesia
    Muscle Weakness
    Possible Paralysis

    Clinical Manifestations
    Rapidly evolving (hours to days)
    Areflexic motor paralysis: Rubbery legs
    Sensory loss Proprioception
    Usually upward progressing
    Lower cranial nerves: OP dysphagia
    Pain: Deep aching pain
    Transient bladder dysfunction

    Other Clinical Manifestations


    Autonomic Dysfunction: Wide fluctuations in

    BP, Orthostatic Hypotension, and Cardiac


    Arrhythmias
    SIADH

    Antecedent Events
    70% of cases occur 1-3 weeks after infectious

    process
    20-30% of all cases are associated with
    Campylobacter jejuni (summer outbreaks in
    China among kids and young adults)
    Also HHV, CMV or EBV
    Mycoplasma pneumoniae
    Recent Immunizations
    Lymphoma (Hodgkins)
    HIV
    SLE

    Molecular Mimicry
    Immune responses to non-self antigens
    Misdirect to host nerve tissue through resemblance
    Neural targets are gangliosides, particularly at the

    Nodes of Ranvier

    Molecular Mimicry

    Diagnosis
    Rapid development of muscle paralysis,

    areflexia, absence of fever


    CSF: Elevated protein level without
    pleocytosis
    EMG and Nerve conduction show slowing
    CSF and EMG are used to verify symptoms
    but may not be abnormal until a week after
    onset

    Required Diagnostic Criteria


    Progressive, relatively symmetrical weakness

    of two or more limbs


    Areflexia
    Course < 4 weeks
    Exclusion of other causes

    Supportive Diagnostic Criteria


    Symmetric Weakness accompanied by

    numbness and/or tingling


    Mild Sensory Involvement
    Facial Nerve or other cranial nerve
    involvement
    Absence of fever
    Typical CSF findings
    Evidence of demyelination from EMG

    Differential Diagnosis

    Acute Myelopathies
    Botulism
    Diptheria
    Lyme disease with polyradiculitis
    Porphyria
    Vasculitis Neuropathy
    Poliomyelitis
    CMV polyradiculitis
    Critical Illness Neuropathy
    Myasthenia Gravis
    Poisonings with Organophosphates or arsenic
    Paresis from West Nile Virus
    Spinal Astrocytoma
    Motor Neuron Disease

    Treatment
    There is no cure for Guillain-Barr Syndrome, but
    there are treatments available
    Plasmapharesis
    Immunoglobulins

    Treatment
    Supportive Management: Telemetry, Blood

    pressure Rx, DVT prophylaxis, Vital


    Capacity/NIF
    High dose IVIg or PLEX: Two weeks after the
    first motor symptom immunotherapy is no
    longer effective
    Meta-anaylsis of randomized clinical trials
    indicate Rx reduces the need for mechanical
    ventilation by 50% and increases the
    likelihood of full recovery at one year from
    55% to 68%
    Steroids have not shown to be effective

    Prognosis
    Most of the time recovery starts after the 4 th

    week from onset of disease


    80% complete recovery within months to a
    year; Areflexia usually persists
    5-10% have relapse CIDP
    Mortality rate is <5% in optimal settings
    Death results usually from pulmonary
    complications

    Thanks for your attention

    Good Luck and Never Give Up

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