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Guillan Barré syndrome * - Coggle Diagram
Guillan Barré syndrome *
UpToDate 2022.04.20
pathogenesis
antecedent infection: GI or respiratiry
Campylobacter, EBV, CMV, Mycloplasma pneumoniae, influenza-like, HIV
molecular mimikri
acute immune-mediated polyneuropathies
clinical features
physical exam
lower extremity symmetric ascending weakness hours/days - involve arms, respiratory muscles diminished/absent reflexes + gait abnormalities
positive sensory symptomes: pain, paresthesia
initial: paresthesia of fingertips and toes
autonomic dysfunction
cranial nerve involvement - bilateral facial weakness common
rare: CNS involvement
clilnical cours: nadir: 2-4 w, return: weeks-mo
subtypes
acute inflammatory demyelinating polyneuropathy AIDP: prototype
acute motor axonal polyneuropathy AMAN -recovery similar to AIDP
acute motor-sensory axonal polyneuropathy AMSAN - more prolonged and severe -uncommon in children
Miller-Fisher sy: external ophtalmoplegia + ataxia + muscle weakness + areflexia. Incomplete forms: ophtalmoplegia +/- ataxia; ataxia +/- opthalmoplegia. BAEP - central and peripheral conduction defects. Anti-GQ1b
Bickerstaff encephalitis: brainstem encephalitis encephalopathy + hyperreflexia +/-opthalmoplegia, ataxia. Anti-GQ1b. Respont to IVIG/PLEX
polyneuritis cranialis: acute bilateral multiple cranial nerve involvement: bilateral facial weakness, dysphagia, dysphonia + severe peripheral sensory loss - preceding CMV. MRI post-contrast enchancement cranial nerve roots
pharyngeal-cervical-brachial weakness: acute weakness of oropharyngeal, neck, sholder muscles, swallowing dysfuncion +/-facial weakness. Anti-GQ1b, Anti-GT1a
other
acute pandysautonomia: diarrhea, vomiting, dizziness, ileus, orthostatic hypotension, urinary retention, pupillary abnormalities, invariant heart rate, decreased sweating, salication, lacrimation
pure sensory GBS: areflexia
facial diplegia + distal limb paraesthesia
sixth nerve palsy + radiculopahty
parapapresis: weakness restricted to legs at presenataion
diagnosis
clinical
no single investigation can confirm/disprove diagnosis