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GUILLAIN-BARRE SYNDROME (GBS)

Neurology

GUILLAIN-BARRE SYNDROME (GBS)

1. Most common autoimmune, inflammatory polyneuropathy, has demyelinating (most common) and axonal variants. Pure motor illness with associated autonomic and urinary retention.

2. A mild gastrointestinal or respiratory infection precedes the polyneuropathy. Ocassionally A/W meningococcal & influenza vaccines.

3.  Acute inflammatory demyelinating polyradiculoneuropathy [AIDP] - classic demyelinating GBS presents as an ascending paralysis of muscles, including respiratory muscles, with areflexia.

4. Miller Fisher axonal variant ([MFV]; 5% of cases) - a type of GBS that includes only areflexia, ataxia, and ophthalmoplegia; e.g., patients unable to move their eyes or walk upright. A/W Campylobacter infection.

5. Two other axonal nariants - para-paretic (partial paralysis) & ataxic.

6. In patients with any type of GBS, the CSF has a normal cell count and a high protein ("protein-cell dissociation"). Anti-GQ1b IgG is a unique serum protein measurable in over 80% of MFV cases of GBS.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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