1. COMPILED BY
Nazar deen FAROOQI
IPM&R,DUHS

2.  Landrys ascending paralysis.
 Acute inflammatory demyleniating poly
neuropathy (AIDP)
 Acute idiopathic polyneuritis
 French polio
 Landry Guillain Barre syndrome.

3.  GBS is an autoimmune disease marked by an acute inflammation
of the peripheral nerves effecting arms and legs.
 It is characterized by weakness and numbness or tingling in legs,
arms, and possible loss of movement in upper body and face.
 Involves destruction of myelin sheath surrounding largest most
myelinated sensory motor fiber.
 Resulted in disruption of proprioception and weakness of limbs.
 In more severe cases complete paralysis and breathing difficulty
noted.
 In most cases GBS follows recent viral and bacterial infections.

4.  No clear cause.
 Neither contagious nor hereditary.
 Possible vaccine causal link.
 Autoimmune----body produces antibodies that
damages myelin sheath.
 In about half of all cases the onset of symdrom follows
viral or bacterial infections.
 Camphylobacteriosis---usually eating uncooked
poultry.
 Influenza
 Gastrointestinal viral infection.
 HIV

5. •Porphyrin----rare disease of RBC.
•Viral hepatitis.
• Epidural anesthesia.
•Thrombolytic agents.
•Small number of cases have been known to occur after minor surgeries
• GBS has been associated with systemic processes like
•Hodgkin’s disease.
•SLE
•Sarcoidosis
•EBV, CMV,
•Lyme disease.
•Mycoplasma.

6.  Hypotonia and areflexia (absence of reflexes).
 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.

7. •The initial symptoms are SENSORY CHANGES: paresthesia,
numbness; usually mild; 70% pts have sensory abnormalities.
•burning,tingling,shocklike,persistent in 5-10%
•WEAKNESS- ascending and symmetrical, lower limbs
involved first, proximal muscles involved earlier; develops
acutely and progresses; wide variations in severity.
•AUTONOMIC CHANGES: tachycardia, bradycardia, facial
flushing, paroxysmal HTN, orthostatic hypotension,
anhidrosis,diaphoresis, urinary retention, ileus, dizziness;
more common if severe weakness or respiratory failure.

8.  It is characterized by focal segmental
demyelination with perivascular and endoneurial
infiltrates of lymphocytes and monocytes or
macrophages.
 These lesions are scattered throughout the
nerves, nerve roots. And cranial nerves.
 In particularly severe lesions, there is both
axonal degeneration and segmental
demyelination
 During recovery, remyelination occurs, but the
lymphocytic infiltrates may persist.

9.  Affects 2/100000 annually.
 None-discriminatory, can effects persons of
any gender, age.

10.  80% experience complete recovery.
 Recovery may last for 2 months to 2 years, It has three distinct
phases.
 Acute (4 weeks) initial rapid onset of symptoms.
 Plateau (few days to few weeks). Symptoms neither worsen nor
improve.
 Recovery (gradual improvement or recovery is accompanied by
pain and tingling in limbs.
 Childrens makes better recovery than adults.
 Recent studies on the disease demonstrate that approximately
80% patients have Myelin loss while 20% have Axon loss.
 5% dies because of cardiopulmonary complications.

11.  GBS is difficult to diagnose because of
symptoms varying and due to no specific
cause.
 Physical and neurological examination.
 Lumber puncture (high protein contents is
demonstrated in CSF).
 NCS (showing flowing o nerve conduction in
nerves root and in peripheral nerves
 EMG (Ineffective tool)

12.  Limited physical mobility.
 Inability to engage in meaningful occupation
because of pain.
 Extreme muscle weakness in arms and legs.
 Fatigue.
 Sensory functions impaired.
 Mental confusion.

13.  Medical
 GBS should be considered as medical
emergency.
 Intravenous immunoglobulin therapy.
 It prevents immune system from further
attacking Schwann cells and myelin sheath,
brocking receptor and microphage
 Plasmapheresis
 Filters blood plasma to remove antibodies. It can
shorten the course, alleviates symptoms in
prevent paralysis.

14. •Corticosteroids
•It inhibit inflammation associated with symptoms.
• Muscle relaxant/ anticonvulsant / pain killer.

15.  Before recovery begins (PROM)
 After symptoms subside (ARON)
 Positioning .
 Active muscle strengthening.
 Mobility skills. Training with adaptive devices
such as wheel chairs or braces.
 Hydrotherapy. Whirlpool hydrotherapy may
release pain and useful in retraining the
movements of effected limbs.
 Counseling. To feel positive about their disease.