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Conditions in OTProf. S. St. Louis.Dominican University of California
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GUILLAIN-BARRÉ SYNDROME
Linda Roybal & Sarah Jane Calub
DESCRIPTIONAcute 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 reflexes 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
Physical and neurological exam
Lumbar puncture
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
REFERENCES
Guillain-Barré Syndrome Support Group (2009) A Quick Guide to Guillain-Barré Syndrome and
CIDP. Guillain-Barré Support Group, Sleaford.
Little evidence that supports a causal link between most vaccines and Guillain-Barre syndrome.
(2009). Drugs & Therapy Perspectives, 25(11), 21-23.
Lugg, J. (2010). Recognising and managing Guillain-Barre syndrome. Emergency Nurse, 18(3),
27-30.
Lundy-Ekman, L. (2007). Neuroscience: fundamentals for rehabilitation (3rd ed.). St. Louis,
Mo.: Saunders/Elsevier.