SHM's Clinical Quick Talks-Guillain-Barré Syndrome (GBS)

Pdf Summary

Guillain-Barré Syndrome (GBS) is a condition characterized by rapidly ascending weakness and inflammation-mediated damage of peripheral nerve myelin. It typically starts in the lower limbs and can lead to difficulty walking, affecting the trunk, arms, face, and breathing muscles. Diagnostic features include decreased reflexes and elevated spinal fluid protein. GBS can be caused by upper respiratory or gastrointestinal infections, as well as other triggers such as surgery, pregnancy, and certain vaccinations. One theory suggests that the immune system attacks the nerve due to similarities between immunogenic molecules of a microbe and those in the peripheral nerve. GBS is the most common cause of acute flaccid paralysis, with an incidence of 1 to 2 new cases per 100,000 population per year. The diagnosis can be challenging, as symptoms can vary widely and may be mistaken for anxiety or other conditions. Physical examination may reveal a waddling gait and diminished reflexes. Laboratory tests and nerve conduction studies can help confirm the diagnosis. Treatment involves disease-specific interventions, such as intravenous immune globulins and plasma exchange, as well as supportive care to manage symptoms. Recovery typically begins after the initial onset of symptoms, with strength returning in a descending pattern over weeks to years. Most patients reach full or nearly full recovery, but some may experience chronic major weakness and chronic paresthesias. Relapses are rare. It is important to treat GBS as a medical emergency due to the risk of cardiopulmonary collapse. Overall, GBS is a challenging condition that requires prompt diagnosis and effective management to optimize outcomes.

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Joel Steinberg

Keywords

Guillain-Barré Syndrome

ascending weakness

inflammation

peripheral nerve myelin

difficulty walking

immune system

acute flaccid paralysis

symptom management

recovery

diagnosis