procedures 3

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Author:
kellymillerSPTA
ID:
193508
Filename:
procedures 3
Updated:
2013-01-17 21:29:02
Tags:
neuro
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Description:
Guillain Barre
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  1. GB Pathology
    • autoimmue response leads to demyelination of nerve fibers which results in inflammation
    • slowed nerve conduction
    • axons are usually preserved
    • 2-3 after attack Schwann cells recover
  2. GB Clinical Feature
    • usually begins in LE and effects them more
    • ascending paraylsis
    • motor involvement worse than sensory
  3. Why can GB be dangerous
    • If if affects the ANS and reaches the phrenic nerve that controls the diaphragm and respiration
    • 30% of pts
  4. Signs of Cranial Nerve Involvement
    • problems swallowing(dsyphagia)
    • lack of facial expression
    • dysarthria
    • diplopia
    • Bulbar palsy (cranial nerve paralysis)
  5. Pain
    • is severe and very common
    • muscle belly pain (myalgia)
    • hard to manage
  6. Plasmaphoresis
    • blood is removed from the body, only red and white cells are returned
    • this removes the immune factors in the plasma that cause the disease
  7. Immunoglobulins
    given intravenously is useful to modulate the severity of the disease
  8. Prognosis
    • 2.6% mortality
    • 80% of pts recover after 1 year but not always fully
    • recovery occurs opposite of onset
  9. Phases of GB
    • Acute
    • Plateau
    • Recovery
  10. Acute
    • symptoms appear and worsen
    • last up to 6 weeks
    • have: paresthesias, motor areaflexia, and weakness is all limbs
  11. Plateau
    • symptoms stay the same
    • last up to 4 weeks
  12. Recovery
    • begins when improvement starts
    • takes months to years
  13. PT in Acute Stage
    • monitor vitals
    • PROM
    • postioning
    • gentle chest stretching
    • cradle garments snug
  14. PT in Plateau
    • upright positioning when resp & ANS are stable
    • heat maybe allowed to help with pain
    • continue from acute stage
  15. PT in Recovery
    • Return of mm strength begins
    • careful strengthening programs
    • continue to monitor, splint, and TT
  16. Exercise for GB
    • Short periods of non fatiguing
    • advance intensity after 1 wk
    • improve function vs. solely improving strength
    • bedrest if deteriorate

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