Thursday, March 25, 2010

-Guillain Barré syndrome.

Guillain Barré syndrome


  • Postinfection:50% of cases have preceding respiratory or GIT viral infection.
  • Post vaccination:following vaccination against swine flu virus.
  • Lymphoma.
  • Autoimmune theory.
Clinical Picture:-
1-Initial febrile illness.
2-Motor affection:-

  • Bilateral symmetrical ascending affection of both lower limbs,trunk,upper limbs,Bulbar muscles,facial muscles then diphragm and respiratory muscles.
  • The Affection is proximal more than distal in adult.
  • The Affection is proximal more than distal in infant and childrens.
  • Weakness is associated with hypotonia and areflexia.
3-Sensory affection:-
Glove and stoke hyposthesia.
4-Autonomic affection:-
Incontinence of urine or retention.
Abnormal pulse and blood pressure.
5-Papilloedema (Due to increase CSF proteins and decrease CSF absorption).


  • CSF:- cytoalbuminous dissociation.
  • Nerve conduction velocity:- decreased.
  • EMG:- acute dennervation of muscle.

Treatment:-   "Spain"

  • Subcutaneous heparin to prevent DVT.
  • Plasmapharesis (must be done in the first 2 weeks).
  • Assisted ventilation.
  • Intravenous immunoglobulins(IVIG):0.4g/KG/day for successive 5 days.
  • Nasogastric tube feeding for bulbar palsy.

Dr Ibrahim
Return to list of medical syndromes here


Nice to see your comment here........