Gbs Journal

7/22/2019 Gbs Journal

1/16

Guillain Barre Syndrome

Journal Reading

Fathia Rachmatina

030.08.099


2/16

Definisi

Guillain Barre syndrome ( GBS ) adalah

suatu kelainan sistem kekebalan tubuh

manusia yang menyerang bagian darisusunan saraf tepi dirinya sendiri dengan

karekterisasi berupa kelemahan atau

arefleksia dari saraf motorik yang sifatnya

progresif. Kelainan ini kadang kadang

juga menyerang saraf sensoris, otonom,

maupun susunan saraf pusat.


3/16

Epidemiologi

The reported incidence of GBS in Western

countries ranges from 0.89 to 1.89 cases

per 100.000 person-years

The incidence increases gradually with

age, but the disease may occur at any

age. Men and women are affected equally


4/16

Etiologi

Infeksi

GBS sering sekali berhubungan dengan infeksi akut non

spesifik. Insidensi kasus GBS yang berkaitan dengan

infeksi ini sekitar antara 56% - 80%, yaitu 1 sampai 4

minggu sebelum gejala neurologi timbul seperti infeksi

saluran pernafasan atas atau infeksi gastrointestinal.


5/16

Patogen yang tersering ditemukan

adalah Campylobacter jejuni, cytomegalo

virus(CMV),Mycoplasmapneumonia,

Epstein-Barr virus, dan virus influenza.


6/16

Gejala Klinis

GBS ditandai dengan timbulnya suatu

kelumpuhan akut yang disertai hilangnya

refleks-refleks tendon dan didahului

parestesi dua atau tiga minggu setelahmengalami demam disertai disosiasi

sitoalbumin pada likuor dan gangguan

sensorik dan motorik perifer.


7/16

Variants

Classical GBS

Recurrent GBS

Miller-Fisher syndrome is characterized bygait ataxia, areflexia, andophthalmoparesis.

Acute sensory polyneuritis

Acute panautonomic neuropathy Acute axonal variant of GBS


8/16

Miller Fisher Syndrome

The Miller Fisher syndrome appears to be

more common among patients with the

GuillainBarr syndrome who live in

eastern Asia than among those who live inother parts of the world


9/16

Most patients with the Miller Fisher

syndrome have evidence of infection 1 to

3 weeks before the development of

ophthalmoplegia or ataxia; in one study,20% of patients had C. jejuni infection and

8% had Haemophilus

influenzae infection.The presence of distalparesthesia is associated with the Miller

Fisher syndrome.


10/16

Diagnosis:

Albuminocytologic dissociation: elevated

CSF protein w/ normal WBC (80-90% pts)

Electromyography (EMG) helps confirm

diagnosis = prolonged or absent F waves


11/16

Patofisiologi


12/16

Terapi

Monitoring cardiac and pulmonary

dysfunction

Prevention of pulmonary embolism

Immunotherapy


13/16

Immunotherapy

Plasma exchange was the first treatment

that was found to be effective in hastening

recovery in patients with the Guillain

Barr syndrome, and it appeared to bemost effective when it was started within

the first 2 weeks after disease onset in

patients who were unable to walk.


14/16

An electrophysiological examination is not

always required for the initiation of

immunotherapy. Plasma exchange

nonspecifically removes antibodies andcomplement and appears to be associated

with reduced nerve damage and faster

clinical improvement, as compared withsupportive therapy alone


15/16

Prognosis

Pada umumnya penderita mempunyai prognosa yang

baik tetapi pada sebagian kecil penderita dapat

meninggal atau mempunyai gejala sisa.

95% terjadi penyembuhan tanpa gejala sisa dalam

waktu 3 bulan bila dengan keadaan antara lain:

pada pemeriksaan NCV-EMG relatif normal

mendapat terapi plasmaparesis dalam 4 minggu mulai

saat onset

progresifitas penyakit lambat dan pendek

pada penderita berusia 30-60 tahun


16/16

Documents

Gbs Journal