gbs serious condition ppt.pptx

7/25/2019 GBS serious condition PPT.pptx

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Guillain-Barré

Syndromea rare and serious condition of the peripheral

nervous system. It occurs when the body'simmune system attacks part of the nervous

system.



EI!"!G#

GBS is common to all races and a$es%mild increase in fre&uency in patientsbetween a$es (-)(% GBS is less

common in infants or the elderly. GBS has a yearly incidence of (.*-+.,

cases+((((( population.

/rior infection is well established as aprecipitatin$ event in thedevelopment of GBS. GBS precededby an acute illness +-0 weeks before

in about 1)2 of cases.



EI!"!G#

GBS may rarely develop within aday or two or after 0-* weeks ofan acute illness.

3ost antecedent illnessesassociated with GBS a4ect theupper respiratory or GI

tracts. Cytomegalovirus (CMV) is the

most common viral antecedent

infection with serolo$ic evidence



EI!"!G#

Epstein Barr (EBV) infection mayprecede GBS in about +(2 of cases%precedin$ clinical si$ns include

mononucleosis hepatitis or pharyn$itis. GBS may occur with HIV

seroconversion. Camplylobacter jejuni (C. jejuni ) is

overall the most common antecedentinfection and has been reported in up to52 of cases.

GBS may possibly occur after surgery,

trauma, an in t!e post"partum



/67!GE8ESIS

Guillain-Barré syndrome is anautoimmune isorer thata4ects the nerves.

In Guillain-Barré syndrome theimmune response dama$esperipheral nerves which are thenerves that connect the centralnervous system 9the brain andspinal cord: to the limbs and

or$ans.



/67!GE8ESIS

Speci;cally the immuneresponse a4ects a particular partof peripheral nerves calleda#ons which are the e<tensionsof nerve cells 9neurons: thattransmit nerve impulses.

Guillain-Barré syndrome cana4ect the neurons that controlmuscle movement 9motor

neurons:%



/67!GE8ESIS

he neurons that transmitsensory si$nals such as paintemperature and touch 9sensoryneurons:% or both.

6s a result a4ected individualscan e<perience muscle weaknessor lose the ability to feel certainsensations.



#/ES

$cute In%ammatory&emyelinating'olyraiculoneuropat!y($I&')

In 6I=/ the immune responsedama$es myelin which is thecoverin$ that protects a<ons andpromotes the e>cienttransmission of nerve impulses.



#/ES

$cute motor a#onalneuropat!y ($M$)

he a<ons of motor neurons aredama$ed.

$cute motor"sensory a#onalneuropat!y ($M$).

he a<ons of motor and sensoryneurons are also dama$ed.



#/ES

Because of sensory nervedama$e a4ected individuals canlose the ability to sense theposition of their limbs and canhave abnormal or absent re?e<es9are?e<ia:.



#/ES

Miller *is!er ynrome

Involves cranial nerves which

e<tend from the brain to variousareas of the head and neck.3iller @isher syndrome ischaracteriAed by three featuresweakness or paralysis of themuscles that move the eyes9ophthalmople$ia: problems

with balance and coordination



C"I8IC6"368I@ES6I!8S

3uscle weakness or paralysis. heweakness often be$ins in the le$s andspreads to the arms torso and face and

is commonly accompanied bynumbness tin$lin$ or pain.

=yspha$ia and =yspnea.

!ccasionally the nerves that controlinvoluntary functions of the body suchas blood pressure and heart rate area4ected which can lead to ?uctuatin$

blood pressure or an abnormal



=I@@EDE8I6"=I6G8!SIS

7istory takin$ Standard blood tests

Cerebrospinal ?uid e<amination Electromyo$raphy may be

helpful to establish the dia$nosis.



8EFD!"!GICE63I86I!8

@acial weakness 9cranial nerveHII: is observed most fre&uentlyfollowed by symptomsassociated with cranial nerves HIIII II H I and .

Fpper e<tremity trunk facial

and oropharyn$eal weakness isobserved to a variable e<tent.

De?e<es are absent or reduced

early in the disease course.



DE63E8

'lasma E#c!ange ('E) or'lasmap!eresis

a process in which some of thepatient's blood is removed theli&uid part separated and theblood cells returned to the body

has been used for severe cases.



DE63E8

Intravenous Immunoglobulin(IVIg)

healthy immuno$lobulin is takenfrom blood donors and $iven tointravenously 9directly into avein:. he healthy antibodies

block and destroy the harmfulantibodies that are attackin$ thenerves. IHI$ is $iven usually

every day for ;ve days. Each



3686GE3E8

Supportive Care ICF monitorin$ basicmedical mana$ement

3aintainin$ Despiratory @unction 3onitorin$ for chan$es in vital capacity and

ne$ative inspiratory force 3echanical ventilation is re&uired if the vital

capacity falls makin$ spontaneous breathin$impossible and tissue o<y$enationinade&uate.

Suctionin$ may be needed to maintain a

clear airway.



3686GE3E8

@or autonomic dysfunction 6ssessment of B/ and 7D

fre&uently. Sustained hypertension mana$ed

by 6CE inhibitor or beta blockin$a$ent.

/ostural hypotension treatedwith ?uid bolus or positionin$.

Frinary di>culties may re&uireintermittent catheteriAation.



3686GE3E8

@or nosocomial infections 6ntibiotic therapy should be

reserved.

@or =eep Hein hrombosis

Dan$e-of-motion e<ercisesposition chan$es anticoa$ulationthe use of anti-embolism stockin$sor se&uential compression bootsand ade uate h dration decrease



3686GE3E8

8utritional Support 6dminister IH ?uids and

parenteral nutrition as asupplement and monitor for thereturn of bowel sounds.

8aso$astric tube needed inpatients who are intubated orhave si$ni;cant oropharyn$ealweakness.



/D!G8!SIS

Desults of studies on recovery ratesdi4er but most indicate that *(2 to 1)2of patients recover completely.

Desidual de;cits of varyin$ de$ree occurin 5(2 to 5)2 of patients. Desidualde;cits are most likely in patients withrapid disease pro$ression those whore&uire mechanical ventilation and those*( years of a$e or older.

=eath occurs in )2 of cases resultin$

from respiratory failure autonomic

gbs serious condition ppt.pptx

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