Guillain-Barre Syndrome Essay -- Medical Science Scientific Medicine E

Guillain-Barre Syndrome Guillain-Barre Syndrome, or acute inflammatory demyelinating polyneuropathy, is a self-limiting disease characterized by areflexia and acute progressive motor weakness of at least one limb. Other symptoms include motor weakness of the extremities and face, loss or reduction of deep tendon reflexes, decreased sensation throughout the body,ophthalmoplegia, and ataxia. In severe cases respiratory failure and autonomic dysfunction may occur. Respiratory failure results from the demyelination of the phrenic and intercostal nerves. Consequently, the person loses the ability to inhale and exhale. Autonomic dysfunction resulting from the demyelination of the sympathetic and vagus nerves can lead to cardiac arrhythmias, tachycardia, postural hypotension, and hypertension. Analysis of the cerebral spinal fluid (CSF) shows increased protein concentration with few cells. Other tests reveal a decreased nerve conduction velocity resulting from segmental demyelination with mononuclear cell infiltra tion. In 70% of the afflicted individuals, the symptoms of Guillain-Barre Syndrome (GBS) occur within two weeks following infection. Clinical diagnosis is based on the presence of albumino-cytological dissociation in the CSF. Following the onset, motor weakness progressively deteriorates for four weeks and may lead to respiratory failure and cardiac instability. If either respiratory failure or cardiac abnormalities occur, the patient will be placed in the intensive care unit and closely monitored. Eventually the person's condition will cease to deteriorate, and he/she will enter a plateau period of two to four weeks during which little or no change will occur. Following the plateau stage, the patient will gradually rec... ...Guillain Barre syndrome following immunisation with Haemophilusinfluenzae type b conjugate vaccine. Europ. J. Pediatrics, July 1993, 152(7): 613-614. Hartung, H. P. Immune-mediated demyelination. Ann. Neurology, June 1993, 33(6): 563-567. Hund, E. F., Borel, C. O., Cornblath, D. R., Hanley, D. F. & McKhann, G. M. Intensive management and treatment of severe Guillain-Barre syndrome. Crit. Care Medicine, March 1993,21(3): 433-446. Rostami, A. M. Pathogenesis of immune-mediated neuropathies. Pediatrics Res., January 1993, 33(1 Suppl): S90-94. Sharief, M. K., McLean, B. & Thompson, E. J. Elevated serum levels of tumor necrosis factor-alpha in Guillain-Barre syndrome. Ann. Neurology, June 1993, 33(6): 591-596. Willison, H. J. & Kennedy, P. G. Gangliosides and bacterialtoxins in Guillain-Barre syndrome. J. Neuroimmunology, July 1993, 46(1-2): 105-112.