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m An autoimmune attack on the

peripheral nerve myelin


m Results to acute, rapid segmental
demyelination of peripheral nerves and
some cranial nerves, producing
ascending weakness with  
inability to execute voluntary
movements), hyporeflexia, and
 
numbness).
m Ãirst described by Landry in 1859, occurs
throughout the world, affects children
adults of both sexes, but is more prevalent
on men, and all age groups equally, and
occurs in all seasons of the year
m Commonly caused by viral agents:
 À  

 À
  
 
  
 ¦   
     
 ½     ½
m An increased incidence of Guillain-Barré
syndrome occurred after influenza
vaccination in 1976-1977 therefore, the
syndrome continues to be tracked in the
vaccine adverse events reporting
system)
m Annual worldwide incidence of Guillain-
Barré syndrome:
 G.6 to 1.4 cases per 1GG,GGG
m ¦ore frequent in males between 16 and
25 years of age and between 45 and 6G
years of age
LEGEND:

Disease Process ±

Disease Factors ±

Complications ±

Signs and Symptoms ±

Diagnostic/Laboratory Exams ±

Medical Management ±
£ ½£½ 
  

£ £ £  £

 

  Post-Infection of:
6ge ± 16-25; 45-60 years old ‡À  

Sex ± More prevalent on MEN ‡À  

‡ 



‡   
‡   
‡     
 HIV)
‡
  ! " 

Hodgkin¶s Lymphoma
Surgery
Mononucleosis
Rarely, Rabies/Influenza immunizations
Poor hygiene
Stress/Lifestyle
Food Poisoning

Invasion of causative agents

Enters the body by the use of


multifenestrated cells or other mechanisms
6ctivation of innate immune response

åptake of the pathogens by


immature antigen presenting cells

Migration to lymph nodes, a mature,


differentiated antigen presenting cell can Pathogen and host have homologous or
present in major histocompatibility identical amino acid sequences, antigens
complex molecules and activate CD4T in its capsules are shared with nerves
cells that recognize antigens from the
infectious pathogens

6ntibodies will be produced, leading to


activation of the complement system
and phagocytosis of the bacteria

¦ 
¦¦ 
infectious organism contains an
amino acid that mimics the peripheral
nerve myelin protein

Failure of the immune system to


distinguish between the two proteins

 ¦¦ 


 is the consequence of an immune
response against self antigens that
results in the damage and eventual
dysfunction of target organs

Immune responses directed against the


capsular components produce
antibodies that cross react with myelin

Lymphocytes and macrophages migrate


into the areas adjacent to the nerve

Lymphocytic infiltration of spinal roots Macrophage-mediated, multifocal


& peripheral nerves stripping of myelin and axonal damage

Demyelination of nerve segments

Increased disruption of the axons


À  
    ± positive for
GBS if these signs are present:
?  ?   ?
   
   Defects in the propagation of
 

 # detects tiny electrical electrical nerve impulses, with
signals on the muscles eventual conduction block
Dull and aching pains
in the lower back, flank
À!$ "   ± unusually high and proximal legs
protein level (600 mg/ml) without
Peripheral nerve denervation
cellular abnormality
and atrophy
%
    ± negative
Loss of
patellar reflex
sweating
& !  forms images of the
body¶s internal structures
%
  - removal of a tiny piece
 ¦   Sinus
of nerve; examined for damage signs  ¦ Tachycardia
  

!
 '
 Hypertension/hypotension
  
 


  "   ¦

  (

IF TRE6TED E6RLY IF TRE6TED L6TE åNTRE6TED

Cell body survives Cell body dies Extensive axonal


destruction

Regeneration of Collateral
peripheral nerves reinnervation from  £


surviving axon
6scending Weakness
progresses
Recovery of motor 6xon regeneration
function


: £  :
Recovery of motor
-Muscle weakness -Blurred Vision
functions, though
-Sensory Changes -Clumsiness and falling
residual deficits
-Paresthesia and numbness in feet -Difficulty moving facial muscles
persists
!  '
 and/or hands -Muscle contractions
  '
 -Loss of reflexes, begins with the -Palpitations
"
 peripheries

Weakening of the ¦  :


diaphragm and x  
   
respiratory muscles x    
x  

-Drooling
Respiratory ? 
   -Fainting
Dyspnea Insufficiency  
 -Facial droop (Dysarthia,
Dysphagia, Difficulty protruding)

  
 !
 
 LEGEND:
? 
   Disease Process ±
   V  
Disease Factors ±

Complications ±


Signs and Symptoms ±

Diagnostic/Laboratory Exams ±
  Medical Management ±
  À  À 
 

 by S. Smeltzer, et.
al. pp. 2288-2289.
£ ½£½ ÀÀ£
 ½ ½ÀÀ£

 C.
Porth. pp. 1136-1137.
£ ½£½ ½À 
    À½ 
! 
 by K. ¦cCance. pp. 579-58G
http://www.cliffsnotes.com/study_guide/Th
e-Brain.topicArticleId-22G32,articleId-
2194G.html#ixzz17vjSPzYe
http://www.cliffsnotes.com/study_guide/Th
e-Spinal-Cord.topicArticleId-
22G32,articleId-
21945.html#ixzz17vjvHoW5
http://www.cliffsnotes.com/study_guide/Tr
ansmission-of-Nerve-
Impulses.topicArticleId-22G32,articleId-
21935.html#ixzz17vkqBiZu
http://www.cliffsnotes.com/study_guide/N
eurons.topicArticleId-22G32,articleId-
21932.html#ixzz17vkVTIvl
http://www.mayoclinic.org/guillain-barre-
syndrome/diagnosis.html
http://www.jsmarcussen.com/gbs/uk/diag
nosis.htm
http://www.scribd.com/doc/38484444/GUI
LLAIN-BARRE-SYNDRO¦E