8/9/2019 Guillan

1/5

Guillain-Barre (gee-YAH-buh-RAY) syndrome is a rare disorder in which your

body's immune system attacks your nerves. Weakness and tingling in your

extremities are usually the first symptoms.

These sensations can quickly spread, eventually paralyzing your whole body.

In its most severe form Guillain-Barre syndrome is a medical emergency. Most

people with the condition must be hospitalized to receive treatment.

The exact cause of Guillain-Barre syndrome is unknown. But it is often

preceded by an infectious illness such as a respiratory infection or the

stomach flu.

There's no known cure for Guillain-Barre syndrome, but several treatments

can ease symptoms and reduce the duration of the illness. Most people

recover from Guillain-Barre syndrome, though some may experience lingering

effects from it, such as weakness, numbness or fatigue.

SYMPTOMS

Guillain-Barre syndrome often begins with tingling and weakness starting in

your feet and legs and spreading to your upper body and arms. In about 10percent of people with the disorder, symptoms begin in the arms or face. As

Guillain-Barre syndrome progresses, muscle weakness can evolve into

paralysis.

Signs and symptoms of Guillain-Barre syndrome may include:

Prickling, "pins and needles" sensations in your fingers, toes, ankles or

wrists

Weakness in your legs that spreads to your upper body

Unsteady walking or inability to walk or climb stairs

8/9/2019 Guillan

2/5

Difficulty with eye or facial movements, including speaking, chewing or

swallowing

Severe pain that may feel achy or cramp-like and may be worse at night

Difficulty with bladder control or bowel function

Rapid heart rate

Low or high blood pressure

Difficulty breathing

People with Guillain-Barre syndrome usually experience their most significant

weakness within two to four weeks after symptoms begin. Recovery usually

begins two to four weeks after weakness plateaus.

Types

Once thought to be a single disorder, Guillain-Barre syndrome is now known to occur in

several forms. The main types are:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP),the most

common form in the U.S. The most common sign of AIDP is muscle weakness that

starts in the lower part of your body and spreads upward.

Miller Fisher syndrome (MFS),in which paralysis starts in the eyes. MFS is also

associated with unsteady gait. MFS occurs in about 5 percent of people with

Guillain-Barre syndrome in the U.S. but is more common in Asia.

Acute motor axonal neuropathy (AMAN)and acute motor-sensory axonal

neuropathy (AMSAN), which are less common in the U.S. but more frequent inChina, Japan and Mexico.

CAUSES

8/9/2019 Guillan

3/5

The exact cause of Guillain-Barre syndrome isn't known. The disorder usually

appears days or weeks after a respiratory or digestive tract infection. Rarely,

recent surgery or immunization can trigger Guillain-Barre syndrome.

In Guillain-Barre syndrome, your immune system which usually attacks onlyinvading organisms begins attacking the nerves. In AIDP, the most common

form of Guillain-Barre syndrome in the U.S., the nerves' protective covering

(myelin sheath) is damaged. The damage prevents nerves from transmitting

signals to your brain, causing weakness, numbness or paralysis.

RISK FACTORS

Guillain-Barre syndrome can affect all age groups. But you're at slightly

greater risk if:

You're a man

You're an older adult

Guillain-Barre syndrome may be triggered by:

Most commonly, infection with campylobacter, a type of bacteria often

found in undercooked poultry

Influenza virus

Epstein-Barr virus

HIV, the virus that causes AIDS

Mycoplasma pneumonia

Surgery

Hodgkin's lymphoma

8/9/2019 Guillan

4/5

Rarely, influenza vaccinations or childhood vaccinations

TREATMENT

There's no cure for Guillain-Barre syndrome. But two types of treatments can

speed recovery and reduce the severity of the illness:

Plasma exchange (plasmapheresis).The liquid portion of part of your

blood (plasma) is removed and separated from your blood cells. The blood

cells are then put back into your body, which manufactures more plasma to

make up for what was removed. Plasmapheresis may work by ridding

plasma of certain antibodies that contribute to the immune system's attackon the peripheral nerves.

Immunoglobulin therapy.Immunoglobulin containing healthy

antibodies from blood donors is given through a vein (intravenously). High

doses of immunoglobulin can block the damaging antibodies that may

contribute to Guillain-Barre syndrome.

NURSING INTERVENTION

1. Turn and reposition the patient, and encourage

coughing and deep breathing.

2. If respiratory failure becomes imminent, establish an

emergency airway with an endotracheal tube.

3. Give meticulous skin care to prevent skinbreakdown

and contractures.

!. "erform passive range of motion e#ercises within the

patient$s pain limits.

%. To prevent aspiration, test the gag re&e# and elevate

the head of the bed before giving the patient

anything to eat.

'. To prevent thrombophlebitis, apply antiembolism

stockings or compression boots and give prophylactic

anticoagulants as ordered.

8/9/2019 Guillan

5/5

(. If the patient has facial paralysis, give eye and mouth

care every ! hours.

). *+er bed pan every 3 to ! hours to monitor intake

and output regularly.

. To prevent or relieve constipation, o+er prune -uice

and high bulk diet.

1. /dminister medications as ordered. /nalgesics

may be prescribed to relieve muscle sti+ness and

spasm.

11. "rovide diversions for the patient, such as

televisions, family visits, or listening to the radio.

12. "rovide emotional support to the patient and his

family.