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Guillain-‐Barré Syndrome
de Angelis, Fahey & PaganBIONB 4910
March 16, 2016
Guillain-‐Barrè Syndrome—Overview & Symptoms
• Rare disorder: 6-40 in 1 million
• Body’s immune system attacks Peripheral Nervous System (PNS)• Unknown cause• Sometimes triggered by an infection, surgery or vaccination
• Symptoms:• Weakness and tingling in the extremities• Muscle weakness• Difficulty with facial movements• Severe pain• Heart rate and blood pressure problems• Difficulty breathing• Severe cases: whole body paralysis• Most people recover
• Symptoms peak at 2-4 weeks, then plateaus• Recovery (weeks to years)• Some experience lingering effects (Ex: weakness, numbness, fatigue)
Ref er ences :-‐ Guillain-‐ Bar r e Syndr om e ( 2016) . Mayo Clinic. ht t p: / /www. m ayoclinic. or g/d iseases-‐ co ndit io ns/gu il lai n-‐ bar r e-‐ syndr om e/bas ics/sym pt om s/c on-‐ 20 0258 32. Accessed 15 Mar ch 2016-‐ Guillain-‐ Bar r e Syndr om e ( 2013) . KAA Ar abic Healt h Encyclopedia. ht t ps : / /www. kaahe. or g/healt h/en/530-‐ g ui ll ain-‐ b ar r e-‐ syndr om e. htm l. Accessed 15 Mar ch 2016
-‐ Hughes , R. A. C. , Hadden, R. D. M . , Gr egson, N. A. and Sm it h, K. J . ( 2000) . Pat hogenes is Of Guillain-‐ Bar r e Syndr om e. J our nal of t he Per ipher al Ner vous Syst em , 5: 122–123. doi: 10. 1046/ j. 1529-‐ 8027. 2000. abs ju n-‐ 23. x-‐ Van Door n PA, Rut s L, J acobs BC. ( 2008) . Clinical f eat ur es , pat hogenes is , and t r eatm ent of Guillain-‐ Bar r é syndr om e. Lancet Neur ol. , 7( 10) : 939-‐ 50.-‐ Hughes , R. A C,Cor nblat h, D. R. ( 2005) . Guillain-‐ Bar r è Syndr om e. The Lancet Nov 5-‐ Nov 11, 366, 9497, pg. 1653
Guillain-‐Barrè SyndromePathophys iology of Guillain-Barré
- Acute Inflammatory Demyelinating Polyradiculoneuropathy(AIDP) (Most common)- Acute Motor Axonal Neuropathy (AMAN)- Acute Motor and Sensory Axonal Neuropathy (AMSAN)
AIDP: due to macrophages penetrating myelin sheaths in the peripheral nervous sys tem and “s tripping” neurons bare. Location of inflammation correlates with motor deficits . Hyp: activated T-cells target macrophages to myelin sheaths . Activated macrophages release free radicals etc.
AMAN-AMSAN: macrophages invade Nodes of Ranvier, leaving myelin wraps intact, but blocking conduction.
Causes- About 2/3 of patients have symptoms of infections before onset of weakness .Hypothes is is that GBS caused by infection-induced immune response that
becomes aberrant and results in damaging of PNS. Early stages very unpredictable.- Common precipitating factors : C. jejuni and cytomegalovirus most correlated with GBS (1/1000), also Eps tein-Barr virus , M. pneumoniae and other
infections .
Findings supporting theory: - Anti-ganglios ide antibodies + other antibodies agains t other glycolipids, T-cells for peripheral nerve proteins . - Manipulations of ganglioside antibodies can induce disease in rabbits .
Guillain-‐Barrè Syndrome: Treatment
REFERENCES: • Guillian-‐ Bar r e Syndr om e Fact Sheet ( 2015) . NI H: Nat ional I nst it ut e of Neur ological Disor der s and St r oke. ht t p: / /www. ninds . nih. gov/dis or der s/gbs/ det ai l_g bs . htm . Accessed 15 Mar ch 2016.
• Diagnos is : Lumbar puncture, Electromyography
• No known cure
• 2 Treatment types : Intravenous immunoglobin or plasmapheres is• Equally effective, but not additive • Becomes ineffective 2 weeks after onset of symptoms
• Treatment of potential complications • Medicine for blood clots (Anticoagulants )• Pain Control• Potentially fatal breathing problems
ht t p: // t exasoncologysanant onio. com /t reatments -‐ser vices/ser vices/plasm apher es is -‐ 1/
ht t p: / /www. ecplaza. net /pr oduct /hum an-‐ imm unoglobulin-‐ ph4-‐f or -‐ int r avenous-‐ -‐ 200753-‐ 1245755. html
ht t p: / /130. 237. 83. 53/medicaldevices/album/Ch%206%20Measur em ent%20m et hods%20&%20values/s lides/F%206-‐20%20Elect r om yogr aphy. htm l
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