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Guillian Barre' (Ground to brain) (Clinical Signs and Symptoms…
Guillian Barre' (Ground to brain)
Diagnostic Testing
CXR
Normal
Increased opacity (when atelectasis or consolidation are present)
PFT
Restrictive lung pathology
Decreased
FVC
FEV1
FEF25%-75%
Lung volume and capacity
VT,IRV,ERV,RV,VC,IC,FRC,TLC
Increased
FEV1/FVC ratio
Early diagnosis, patients have excellent prognosis
Sudden ASENDING paralysis :red_flag:
CSF findings :red_flag:
Elevated protein level (100-1000 mg/dL) with NORMAL WBC count
Albuminocytologic dissociation of the spinal fluid
Nerve conduction studies
Etiology
An auto immune disease developed from an immune response to foreign antigens (infectious agent) that attack the nerve tissue
Pathophysiology
A
irway obstruction
A
lveolar consolidation
A
ccumulation of mucous
A
telectasis
Anatomic Alterations/AAAA
Differential Diagnosis
Sudden ASCENDING paralysis :red_flag:
CSF findings :red_flag:
Elevated protein level (100-1000 mg/dL) with NORMAL WBC count
Albuminocytologic dissociation of the spinal fluid
Respiratory Management
Approximately 30% of cases develop respiratory failure and require mechanical ventilation
Primary treatment should be stabilization of VS and supportive care
Close respiratory monitoring
FVC
MIP
MEP
BP
SpO2
ABG
Impending acute respiratory failure requiring MV
FVC < 20mL/kg
MIP < -30cm H20
MEP < 40cm H20
PaCO2 > 45 mmHg
pH < 7.35
Oxygen therapy
Bronchopulmonary hygiene therapy
Lung expansion therapy
General management
Plasmapheresis (Plasma exchange)
Intravenous immune globulin (IVIG)
Clinical Signs and Symptoms
Symmetric muscle weakness in the DISTAL extremities accompanied by
paresthesia
(tingling,burning, shock like sensations) or
dysesthesias
(unpleasant, abnormal sense of touch)
Pain (throbbing, aching, especially in the lower back, buttocks and legs)
Numbness
Ascending paralysis (extending to the arms, trunks and face)
Weakness and paralysis may develop in 1 day or over several days and peaks at about 2 weeks
Deep tendon reflexes commonly ABSENT
Difficulty chewing, swallowing and speaking
Degree of muscle paralysis will affect the RR
Apnea
Anxiety
Cyanosis
BS: diminished and crackles
An autoimmune disease that causes an acute peripheral nervous system disorder (called polyneuropathy) that results in a flaccid paralysis of the skeletal muscles and loss of muscle reflexes