9. MINILECTURE GBS

8/13/2019 9. MINILECTURE GBS

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NUSHROTUL LAILIYYA M.D.

Department of Neurology-Padjadjaran University-Bandung


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CLASSICAL NEUROIMMUNOLOGICAL

DISORDERSGuillain Barre Syndrome

Chronic diophatic nflammatory Demyelinating Polyneuropathy

!ultifocal !otor Neuropathy

Polyneuropathy "ith !onoclonal Gammopathy

!yasthenia Gravis

!yositis

Stiff-Person Syndromes

Neuromyotonia

Paraneoplastic syndrome

!ultiple Sclerosis


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GUILLAIN BARRE

SYNDROME

Nushrotul Lailiyya M.D.Department of Neurology # !edical $aculty #

Padjadjaran University

Bandung # ndonesia


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ANATOMY OF PERIPHERAL NERE


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GUILLAIN BARRE SYNDROME

%utoimmune disease

&hought to 'e acute demyelinating neuropathy

$irst descri'ed in ()(* 'y Guillain-Barre-Strohl

Peripheral and cranial nerves

%cute+ symmetrical+ motor+ sensory+

autonomic

&hree "ee,s progressive sta'le


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Characteried.

/apidly acsending paralysis

0yporefle1ia

CS$ cytoal'uminologic dissociation

Pathology studies . demyelinating and

mononuclear infiltration in nerve roots

Clinical spectrum a "ide range of

variants


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2radication of polio

!ajor cause of acute paralysis

n adolescent

GBS !!!


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%ssociated &/GG2/S.

U/& *3-435 cases

Gastroenteritis preceded 'y this

symptom in (-6 "ee,

Pregnancy Cancer 70odg,in8s9:accination (;6 . no preceding illness

Surgery


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Cli"i#al s$%#tru& o'

GUILLAIN BARRE

SYNDROME

% "ide range of variants


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GUILLAIN

BARRE

SYNDROME

ARIANTS

MOTOR ()* MOTOR (+*

%DP !iller $isher S

%!S%N Panautonomic

%!%N Pure Sensory


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EPIDEMIOLOGY

ndonesia+ incidence


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EPIDEMIOLOGY

,iral 43-35 -a#t%ria

Citomegalo Campilo'acter jejeni2pstein Barr !ycoplasma pneumoni

0:

Oth%rs syst%&i# /is%as%0

,a##i"atio"0 sur1%ry


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HISTOPATHOLOGY

P2/P02/%E N2/:2S.

2ndoneurial perivascular monocyte infiltration

!ultifocal demyelination%1onal degeneration


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HISTOPATHOLOGY AIDP


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HISTOPATHOLOGY

AMAN2AMSAN


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PATHOGENESIS

mmune attac, on myelin

anti'ody for ganglioside and glicolipid

& cell and cyto,ines

infection


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CLINICAL PRESENTATIONS

CENC%E SF!P&!S 7!onophasic9

3 6 =-* H22IS

&riggers


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Motor

flaccid paralysis

symmetrical+ 'ilateral

ascending 'reath muscle

cranial nerves paralysisreduce of tendon refle1


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EBP+ radicular pain

anesthesia 7glove J stoc,ing9+paresthesia+ tingling

severity in distal

position and vi'ration distur'ances

gait ata1ia


S%"sory


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Auto"o&i#

tachycardia+ 'radycardia+ arrhythmia

hypertension+ postural hypotension

anhydrosis+ hyperhidrosis


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DIAGNOSE

%cute

!onophasic

Clinics K pea, in


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INESTIGATIONS

ECS . dissociation cytoal'uminologic

Serology . gG or g! %B viral

NCS . - NC: L

- prolonged of distal latencies

- amplitude L

2CG . autonomic distur'ances


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DIFFERENTIAL DIAGNOSE

0ypo;hypercalemia SE2

!yastenia gravis nto1ication

Polimyositis Dyphteri

!yelitis Porphyria


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COMPLICATIONS

(3 # (@5 . S2:2/2

CU


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THERAPY

Supportive+ reha'ilitation

Breath paralysis and autonomic distur'ances

CU 7respirator9mmuno-modulations therapy .

- : g

- Plasmaparesis

- Corti,osteroid 7controversial9


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Gold / et al.7


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PREENTION

55mmunity


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PROGNOSIS

@5 spontaneous recovery

n 6-* month


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SUMMARY

GUILLAIN BARRE SYNDROME%utoimmune

Pathogenesis

Preceded 'y . infection

Clinic . acute+ 6 "ee,s

(3-(@ 5 severe . CU

@5 spontaneous recovery . 6 # * month


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9. MINILECTURE GBS