Wednesday, November 4, 2020

GUILLAIN-BARRÉ SYNDROME

 

GUILLAIN-BARRÉ SYNDROME

DESCRIPTION

Acute autoimmune disease marked by inflammation of the peripheral nerves, affecting arms and legs

Involves destruction of the myelin sheath surrounding largest, most myelinated sensory and motor fibers, resulting in disrupted proprioception and weakness.

 

ETIOLOGY

·        No clear cause

·        Neither contagious nor hereditary

·        Inappropriate immune response

·        Possible vaccine causal link

 

INCIDENCE &PREVALENCE

·        GBS affects 2 per 100,000 annually (1,500 people/year)

·        Nondiscriminatory: can affect persons of any gender, age, or ethnic background

SIGNS AND SYMPTOMS

·        Numbness and tingling in hands and feet

·        Distal progression: muscle weakness, diminished reflexe and proprioception, decreased sensation

·        For some, progresses to trunk, face, and cranial nerves,resulting in difficulty swallowing, chewing, speaking, and facial expressions

·        Deep, aching pain/hypersensitivity to touch

·        Respiratory/cardiac dysfunction and failure

 

COURSE/PROGNOSIS

80% experience complete recovery

Recovery may last from 2 months to 2 years

 

3 distinct phases:

Acute (4 wks) - initial rapid onset of symptoms

Plateu (few days to few weeks) - symptoms neither worsen nor improve

Recovery - gradual improvement

 

DIAGNOSIS

Diagnostic testing for GBS includes

1.     Physical and neurological exam

2.     Lumbar puncture

3.     Computed Tomography (CT) scan

 

 

MEDICAL/SURGICAL MANAGEMENT

 

Intravenous immunoglobin therapy: prevents immune system from further attacking Schwann cells and myelin by blocking receptors on microphages

Plasmapheresis: filters blood plasma to remove antibodies and aids in replacing lost fluids

Corticosteroids: inhibit inflammation associated w/symptoms

 

IMPACT ON CLIENT

·        Limited physical mobility

·        Inability to engage in meaningful occupations because of pain, extreme muscle weakness in arms and legs, and fatigue

·        Sensory functions impaired

·        Using cultural contexts to structure intervention activities

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