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In the name of god

In the name of god. Z.Vaseie MD Emergency Medicine Resident. Guillain Barre Syndrom ( gbs ). Guillain Barre Syndrom (GBS). Group of autoimmune conditions involving demyelination and acute axonal degeneration of peripheral nerves

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In the name of god

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  1. In the name of god

  2. Z.Vaseie MD Emergency Medicine Resident GuillainBarreSyndrom(gbs)

  3. GuillainBarreSyndrom (GBS) • Group of autoimmune conditions involving demyelination and acute axonal degeneration of peripheral nerves • Usually preceded by triggering event, e.g., infection(campylobacter jejuni),vaccination • Leading cause of acute flaccid paralysis,progressive symmetrical ascending weakness + decreased DTR+variable sensory finding +sparing anal sphincter • All ages, but rare in infancy

  4. GuillainBarreSyndrom (GBS) • 32% have all 4 extrimities affected at the time of presentation • 10% have weakness that begins in the upperextrimities • Some form of cranial nerve involvement(usually 7)

  5. Variety of GBS • Acute inflammatory demyelinatingpolyradiculoneuropathy (AIDP) • Acute motor axonal neuropathy (AMAN) • Acute motor sensory axonal neuropathy (AMSAN) • Miller-Fisher syndrome (ophtalmoplegia,ataxia,areflexia) 5. Acute panautonomic neuropathy

  6. Paraclinic: • CSF:elevated protein (>45 mg/ dl) with & (white cell counts < 10/cc ) after 7 to 10 days • Electrophysiologic testing(EMG-NCV)

  7. Paraclinic: • MRI:selective enhancement of the anterior spinal nerve roots is suggestive but not diagnostic • Nerve Biopsy:mononuclear inflammatory infiltration

  8. Treatment: Assessment of respiratory function • IVIG 2 gr/kg/day for 2 days • Plasma Exchange • Corticosteroids are no longer recommended

  9. Out come: • Weakness reaches nadir at 2-4 weeks • Spontaneous resolution occurs over weeks to months. • 2% _ 5% mortality

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