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Guillain Barre Syndrome (Clinical features (Ascending paralysis with…
Guillain Barre Syndrome
Clinical features
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Sensory involvement - usually minimal but if present affects the dorsal columns (vibration, proprioception) more than the spinothalamic tracts
Autonomic dysfunction may occur - sinus tachy common, dangerous bradyarrhythmias, postural hypotension
Investigations
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Identification of infection with Campylobacter (most common), Mycoplasma...
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Management
Specific management
Plasma exchange and IVIG both help reduce recovery time (either). IVIG favoured because it is easier to administer and has fewer SEs. No value in both being given routinely - give if non-ambulatory and evidence of resp decompensation
Supportive management
Ventilatory support - needed in 30%. Intubate if Vital Capacity <20ml/kg (~1l). NIV not useful - does not help with inability to eliminate secretions
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PT/OT, nutrition, analgesia, DVT prophylaxis, pressure care
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