Chapter 2: Guillain-Barre Syndrome

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Author:
dmshaw9
ID:
298337
Filename:
Chapter 2: Guillain-Barre Syndrome
Updated:
2015-03-13 14:39:42
Tags:
Guillain Barre Syndrome
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NPTE,Chapter2
Description:
NPTE: Chapter 2
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  1. Definition
    • Polyneuritis with progressive muscular weakness that develops rapidly
    • Involves acute demyelination of both cranial and peripheral nerves (LMN disease)
  2. Etiology
    • Unknown, associated with an autoimmune attack
    • Usually occurs after recovery from an infectious illness (respiratory or GI)
  3. Sensory and Motor Loss
    • Sensory loss and paresthesias (typically less than motor loss)
    • Motor paresis or paralysis (relative symmetrical distribution of weakness)
    • Motor loss rogresses from lower extremities to upper (ascending pattern) and distal to proximal
    • May produce full tetraplegia with respitatory failure
    • Dysarthria, dysphagia, dipolia and facial weakness may develop in severe cases
  4. Prognosis
    • Progression evolves over a few days or weeks
    • Recovery usually slow (6 months → 2 years) and usually complete (85% of cases)
    • Some mild weakness may persist
    • 3% mortality
  5. Complications
    • Respiratory impairment and failure
    • Autonomic instability: tachycardia, arrhythmias, BP fluctuations
    • Pain: myalgia
    • Risk of pneumonia
    • Prolonged hospitalizations and immobility: DVT, skin breakdown, contracture
    • Relapse: if treatment is inadequate
  6. Examine
    • Cardiac and respiratory status, vital signs
    • CN function (VII, IX, X, XI, XII)
    • Motor strength
    • Reflexes: decreased or absent tendon reflexes
    • Sensation: paresthesias, anethesias, hyperesthesias, pain (muscle aching, burning); May have stocking and clove distribution
    • Functional status
  7. Medical Treatment
    • Good nursing care
    • Plasmapheresis
    • IVIG
    • Analgesics for relief of pain
  8. PT Goals, Outcomes, and Interventions
    • Maintain respiratory function (may require endotracheal intubation, intubation, tracheotomy, and ventilation)
    • Prevent indirection impairments: PROM, positioning, and skin care
    • Prevent injury to denervated muscles
    • Muscle re-ed, moderate exercise program
    • Functional training as recovery progresses
    • Energy conservation techniques (overuse and fatigue prolong recover)
    • Cardiovascular fitness

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