What are the main clinical features of Guillain-Barre syndrome?

• progressive, symmetrical weakness of all the limbs.
  • the weakness is classically ascending i.e. the legs are affected first
  • reflexes are reduced or absent
• sensory symptoms tend to be mild (e.g. distal paraesthesia) with very few sensory signs

What is the management of Guillain-Barre syndrome?

• IV immunoglobulins (IVIG) or plasma exchange can be used
• FVC regularly to monitor respiratory function

What is the pathophysiology of Guillain-Barre syndrome?

cross-reaction of antibodies with gangliosides in the peripheral nervous system

What is a serious complication of Guillain-Barre syndrome?

respiratory muscle weakness - may need respiratory support

What is Guillain-Barre syndrome?

an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni)

What is the classic bacterial trigger for Guillain-Barre syndrome?

Campylobacter jejuni

What is seen in CSF in Guillain-Barre syndrome?

rise in protein with a normal white blood cell count (albuminocytologic dissociation) - found in 66%

What is seen in nerve condution studies in Guillain-Barre syndrome?

• decreased motor nerve conduction velocity (due to demyelination)
• prolonged distal motor latency
• increased F wave latency

What is the prognosis for Guillain-Barre syndrome?

• severe motor problems persist in about 15%
• around 5% die

What are Poor prognostic features for Guillain-Barre syndrome?

• age > 40 years
• poor upper extremity muscle strength
• previous history of a diarrhoeal illness (specifically Campylobacter jejuni)
• high anti-GM1 antibody titre
• need for ventilatory support

What antibody is seen in Guillain-Barre syndrome?

anti-GM1 antibodies in 25% of patients