Guillain - Barre Syndrome

Note the exact mechanism of Guillain-Barre is unknown and can follow many viral and bacterial infections in addition to those listed below. 

Acute infectious polyneuritis Landry s ascending paralysis Strohl syndrome 

motion - reduced or paralyzed (ophthalmoplegia) [2] Eyes, vision - double (diplopia) 

Sensation, general deep - reduced Skin - sensation reduced (dysesthesia) 

Tendon reflexes - reduced or absent Urination - retention [7] 

Keywords Acute flaccid paralysis Anti-ganglioside antibodies Campylobacter jejuni Experimental allergic/autoimmune neurids (BAN) Gangliosides Immune neuropathies Molecular mimicry T-cells 

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Neurological diseases myasthenia gravis, multiple sklerosis, Guillain-Barre-syndrom... 

Peripheral neuropathy is degeneration of peripheral nerves. Because motor and sensory axons tun in the same nerves, usually both motor and sensory functions are affected in this disease. Neuropathies may be either acute (e.g., Charcot-Marie-Tooth disease) or chronic (e.g., Guillain-Barre syndrome) and are categorized as demyelinating or axonal. 

A generalized systemic illness may accompany HIV seroconversion (Cooper et al. 1985). Guillain-Barre syndrome (GBS) (Piette et al. 1986), unilateral (Wiselka et al. 1987) or bilateral facial palsies (Wechsler and Ho 1989), bibra-chial palsy (Calabrese et al. 1987) and sensory neuropathy (Denning 1988) have been reported to occur during this process, usually within 1-2 weeks of the acute febrile illness. Spinal fluid analysis may show a mild to moderate mononuclear pleocytosis and a mild increase in protein levels. The precise relationship to HIV viral load in the cerebrospinal fluid (CSF) or plasma is unknown (Brew 2003). There is no proven therapy, but most patients recover spontaneously without any treatment. 

Piliero PJ, Fish DG et al (2003) Guillain-Barre syndrome associated with immune reconstitution. Clin Infect Dis 36(9) el 11-el 14... 

The most important postinfectious complication of C. jejuni is Guillain-Barre syndrome (CBS). The risk of developing CBS is very small (less than one case of CBS per 1000... 

Inactivated influenza TIV 0.5 mL Intramuscular Severe egg allergy History of Guillain-Barre syndrome... 

Tetanus, reduced diphtheria, acellular pertussis Tdap 0.5 mL Intramuscular History of Guillain-Barre syndrome Systemic neurologic reaction from previous vaccine... 

Guillain-Barre syndrome is a transient neurologic disorder involving inflammatory demyelination of the peripheral nerves. The syndrome is characterized by progressive symmetric weakness of the legs and arms with loss of reflexes. Occasionally sensory abnormalities and paralysis of respiratory muscles will occur.16... 

The etiology of Guillain-Barr syndrome is unknown, but increasing evidence suggests it is probably a humoral and... 

GBS Group B Streptococcus Guillain-Barre syndrome Hx History... 

Although not reviewed in detail here, C. jejuni and C. coli are another major cause of inflammatory colitis that may be complicated by Guillain-Barre syndrome or reactive arthritis. In addition, their resistance to antimicrobials (particularly to quinolones) is increasing. In the United States, fluoroquinolone resistance of C. jejuni rose from 13% in 1997 to 18% in 1999 [112],... 

Nachamkin I, Alios BM, Ho T Campylobacter species and Guillain-Barre syndrome. Clin Microbiol Rev 1998 11 555-567. 

Suggested Alternatives for Differential Diagnosis Encephalitis, Herpes Simplex, tetanus, Guillain-Barre syndrome, poliomyelitis, transverse myelitis, cerebrovascular accident, psychosis, intracranial mass, epilepsy, atropine poisoning, and Creutzfeldt-Jacob disease. 

Acute inflammatoiy demyelinating polyneuropathy is a common cause of reversible paralysis. Acute inflammatory demyelinating polyneuropathy (AIDP), the classic form of the Guillain-Barre syndrome, often begins a week or two after recovery from cytomegalovirus, Epstein-Barr virus or Mycoplasma infection. Patients present with rapidly advancing symmetrical weakness, loss of deep tendon reflexes, often with distal numbness, and limb or back pain. Cerebrospinal fluid (CSF) protein concentration is elevated, but in most cases there is little or no increase in number of inflammatory cells in the CSF. This albumino-cytologic dissociation contrasts with the elevation of both... 

Magira, E. E., Papaioakim, M., Nachamkin, I. et al. Differential distribution of HLA-DQP/DRP epitopes in the two forms of Guillain-Barre syndrome, acute motor axonal neuropathy and acute inflammatory demyelinating... 

Wanschitz, J., Maier, H., Lassmann, H., Budka, H. and Berger, T. Distinct time pattern of complement activation and cytotoxic T cell response in Guillain-Barre syndrome. Brain 126 2034-2042, 2003. 

Hartung, H. P., Willison, H. J. and Kieseier, B. C. Acute immunoinflammatory neuropathy update on Guillain-Barre syndrome. Curr. Opin. Neurol. 15 571-577, 2002. 

Differential Diagnosis With single cases, rather than clearly epidemic cases, the illness could be confused with Guillain-Barre syndrome, myasthenia gravis, or tick paralysis. Other possible considerations may include enteroviral infections, as well as nerve agent and atropine poisoning. 

Polyneuritis is a disorder of the peripheral nerves. It involves damage to the myelin sheath. The condition is due to inflammation of the axonal membrane caused by viral or bacterial attack, i.e. an antoimmnne disease. Guillain-Barre syndrome is one form of polynenritis and is an example of an autoimmune disease caused by immune mimicry in response to a bacterial or viral antigen. It is discnssed in Chapter 17. 

It is known as Guillain-Barre syndrome. It is named after the French neurologists G. Guillain and A. Barre. Guillain-Barre syndrome is, therefore, an example of molecular mimicry. 

Neurologic symptoms Motor weakness has been reported rarely. Most of these cases occurred in the setting of lactic acidosis. The evolution of motor weakness may mimic the clinical presentation of Guillain-Barre syndrome (including respiratory failure). Symptoms may continue or worsen following discontinuation of therapy. Stavudine therapy has been associated with peripheral neuropathy, which can be severe and is dose-related. Peripheral neuropathy has occurred more frequently in patients with advanced HIV disease, a history of neuropathy, or concurrent neurotoxic drug therapy, including didanosine (see Adverse Reactions). 

Clostridium 18-36h can contain blood. Guillain-Barre syndrome. Dose >500 cfu Neurotoxin affects nervous system leading to from poultry production. Raw poultry Soil, sediments, water... 

They have a delayed onset of effect just like the tricyclics. Examples are fluoxetine, paroxetine, flu-voxamine, zimelidine, venlafaxine, citalopram and sertraline. Zimelidine was withdrawn worldwide in 1983 due to risk of Guillain-Barre syndrome. 

Hughes RAC, Swan AV, van Koningsveld R, van Doom PA. Corticosteroids for Guillain-Barre syndrome. Cochrane Database Syst Rev 2006. 

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