Guillain-Barre Syndrome

Guillain-Barre' Syndrome:  causes segmental demyelination (destruction or loss of the myelin sheath of a nerve or nerves) of the peripheral nerves.  Guillain-Barre syndrome is an acute, rapidly progressive, and potentially fatal form of polyneuritis (inflammation of many nerves simultaneously).  It causes both the posterior (sensory) and anterior (motor) nerve roots, signs of sensory and motor losses occur simultaneously.

Cause:  True cause for Guillain-Barre syndrome is unknown, but it may be a cell mediated immunologic attack on peripheral nerves in response to a virus.  Predisposing factors may include mild febrile illness, surgery, viral illness, Hodgkin's disease or some other cancer, or systemic lupus erythematosus.

Symptoms:

Along with a history of preceding febrile illness (usually a respiratory tract infection) - other signs includes:

Paresthesia ( morbid or perverted sensation; and abnormal sensation, as burning, prickling, formication, etc.)

Muscle weakness  - usually appears in the legs first, then extends to the arms and facial nerves in 24 to 72 hours.  In some patients it may develops in the arms first or in the arms and legs simultaneously.

May have facial diplegia (paralysis of like parts on either side of the body).

May have difficulty swallowing (dysphagia) or imperfect articulation of speech due to disturbances of muscular control (dysarthria)

Less often symptom - weakness of the muscles supplied by the 11th cranial (spinal accessory) nerve.
May have absent of reflexes (areflexia) or diminished tone of the skeletal muscles (hypotonia)

Treatment:

May require prednisone therapy

Treatment is primarily supportive, and patient may require endotracheal intubation or tracheotomy if he has difficulty clearing secretions.

Plasma exchange for patients with this disorder is currently under investigation.

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