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GUILLAIN BARRE SYNDROME DIANA COHEN
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WHAT IS GUILLAIN BARRE SYNDROME AUTOIMMUNE DISORDER UNKNOWN CAUSE
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NORMAL NEURON TYPICALLY CONSISTS OF A CELL BODY, DENDRITES AND AN AXON THE INSULATING COVERING THAT SURROUNDS AN AXON WITH MULTIPLE SPIRAL LAYERS OF MYELIN, THAT IS DISCONTINUOUS AT THE NODES OF RANVIER, AND THAT INCREASES THE SPEED AT WHICH A NERVE IMPULSE CAN TRAVEL ALONG AN AXON
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FORMS OF GBS ACUTE INFLAMMATORY DEMYELINATING POLYNEUROPATHY MILLER FISHER SYNDROME ACUTE MOTOR AXONAL NEUROPATHY ACUTE MOTOR SENSORY AXONAL NEUROPATHY ACUTE PANAUTONOMIC NEUROPATHY BICKERS BRAINSTEM ENCEPHALITIS
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ACUTE INFAMMATORY DEMYELINATING POLYRDICULONEUROPATHY - AIDP MOST COMMON FORM IN THE US CAUSE IS UNKNOWN AGE 15 -35 AND 60-75 RECENT GASTROINTESTINAL OR RESPIRATORY INFECTION EITHER VIRUSES/BACTERIAL MEN MORE LIKELY THAN WOMAN ARE AFFECTED
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NERVE AND DAMAGED MYELIN SHEATH GUILLAIN-BARRE SYNDROME DESTROYS THE PROTECTIVE COVERING OF THE PERIPHERAL NERVES (MYELIN SHEATH), PREVENTING THE NERVES FROM TRANSMITTING SIGNALS TO THE BRAIN. Nerve and damaged myelin sheath Guillain-Barre syndrome destroys the protective covering of the peripheral nerves (myelin sheath), preventing the nerves from transmitting signals to the brain.
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DEMYELINATION THEORY IS THAT AN INFECTED ORGANISM WHICH CONTAINS AN AMINO ACID IS MISTAKEN FOR THE PERIPHERAL NERVE MYELIN PROTEIN, CAUSING THE IMMUNE SYSTEM TO ATTACK ITS OWN NERVES. WITH THE ATTACK THERE IS INFLAMMATION AND DESTRUCTION, LEAVING THE AXON UNABLE TO SUPPORT NERVE CONDUCTION. THIS CAUSES A BREAK IN THE SYNAPSE, SLOWING AND BLOCKING OF CONDUCTION LEADS TO MUSCLE WEAKNESS, DYSPHAGIA, CARDIAC ARRHYTHMIAS AND DYSAUTONOMIA WHICH IS THE LEADING ETIOLOGY
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SYMPTOMS WEAKNESS OR TINGLING SENSATIONS STARTING AT LEGS AND SPREADING TO ARMS AND FACE NUMBNESS LOSS OF REFLEXES IN ARMS AND LEGS UNCOORDINATED MOVEMENT FACIAL WEAKNESS SEVERE PAIN MUSCLE PAIN AND TENDERNESS BLURRED VISION RESPIRATORY PROBLEMS
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DIAGNOSIS IS BASED ON SYMPTOMS AND FINDINGS ON NEUROLOGICAL EXAMINATION INCLUDING DIMINISHED OR LOSS OF DEEP-TENDON REFLEXES. A LUMBAR PUNCTURE MAY BE DONE FOR SUPPORTIVE INFORMATION, THOUGH SHOULD NOT DELAY TREATMENT. OTHER TESTS, SUCH AS BLOOD TESTS, TO IDENTIFY THE UNDERLYING TRIGGER ARE NOT REQUIRED TO MAKE THE DIAGNOSIS OF GBS AND SHOULD NOT DELAY TREATMENT.
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TREATMENT – ACCORDING TO WHO (WORLD HEALTH ORGANIZATION) GUILLAIN-BARRÉ SYNDROME IS POTENTIALLY LIFE-THREATENING. GBS PATIENTS SHOULD BE HOSPITALIZED SO THAT THEY CAN BE MONITORED CLOSELY TWO MAIN INITIAL TREATMENTS ARE INTRAVENOUS IMMUNOGLOBULIN OR PLASMASPHERES (PLASMA EXCHANGE) REHABILITATION TO REGAIN FUNCTIONS THAT WERE NOT LOST
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POTENTIAL COMPLICATIONS - GUILLAIN-BARRE SYNDROME AFFECTS YOUR NERVES. BECAUSE NERVES CONTROL YOUR MOVEMENTS AND BODY FUNCTIONS, PEOPLE WITH GUILLAIN-BARRE MAY EXPERIENCE: BREATHING DIFFICULTIES. THE WEAKNESS OR PARALYSIS CAN SPREAD TO THE MUSCLES THAT CONTROL YOUR BREATHING, A POTENTIALLY FATAL COMPLICATION. UP TO 30 PERCENT OF PEOPLE WITH GUILLAIN-BARRE SYNDROME NEED TEMPORARY HELP FROM A MACHINE TO BREATHE WHEN THEY'RE HOSPITALIZED FOR TREATMENT. RESIDUAL NUMBNESS OR OTHER SENSATIONS. MOST PEOPLE WITH GUILLAIN-BARRE SYNDROME RECOVER COMPLETELY OR HAVE ONLY MINOR, RESIDUAL WEAKNESS, NUMBNESS OR TINGLING. HEART AND BLOOD PRESSURE PROBLEMS. BLOOD PRESSURE FLUCTUATIONS AND IRREGULAR HEART RHYTHMS (CARDIAC ARRHYTHMIAS) ARE COMMON SIDE EFFECTS OF GUILLAIN-BARRE SYNDROME. PAIN. UP TO HALF OF PEOPLE WITH GUILLAIN-BARRE SYNDROME EXPERIENCE SEVERE NERVE PAIN, WHICH MAY BE EASED WITH MEDICATION. BOWEL AND BLADDER FUNCTION PROBLEMS. SLUGGISH BOWEL FUNCTION AND URINE RETENTION MAY RESULT FROM GUILLAIN-BARRE SYNDROME. BLOOD CLOTS. PEOPLE WHO ARE IMMOBILE DUE TO GUILLAIN-BARRE SYNDROME ARE AT RISK OF DEVELOPING BLOOD CLOTS. UNTIL YOU'RE ABLE TO WALK INDEPENDENTLY, TAKING BLOOD THINNERS AND WEARING SUPPORT STOCKINGS MAY BE RECOMMENDED. PRESSURE SORES. BEING IMMOBILE ALSO PUTS YOU AT RISK OF DEVELOPING BEDSORES (PRESSURE SORES). FREQUENT REPOSITIONING MAY HELP AVOID THIS PROBLEM. RELAPSE. AROUND 3 PERCENT OF PEOPLE WITH GUILLAIN-BARRE SYNDROME EXPERIENCE A RELAPSE.
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REFERENCES NEURON ACTION POTENTIALS: THE CREATION OF A BRAIN SIGNAL. (N.D.). RETRIEVED FROM KAHN ACADEMY: HTTPS://WWW.KHANACADEMY.ORG/TEST-PREP/MCAT/ORGAN-SYSTEMS/NEURON-MEMBRANE-POTENTIALS/A/NEURON-ACTION- POTENTIALS-THE-CREATION-OF-A-BRAIN-SIGNAL NIH. (2018, SEPTEMBER 17). GUILLAIN-BARRE SYNDROME INFORMATION PAGE. RETRIEVED FROM NATIONAL INSTITUTE OF NUROLOGICAL DISORDERS AND STROKE: HTTPS://WWW.NINDS.NIH.GOV/DISORDERS/ALL-DISORDERS/GUILLAIN-BARR%C3%A9- SYNDROME-INFORMATION-PAGE UBIN, M. (2018, JULY). GUILLAIN-BARRÉ SYNDROME. RETRIEVED FROM MERCK MANUAL PROFESSIONAL VERSION: HTTPS://WWW.MERCKMANUALS.COM/PROFESSIONAL/NEUROLOGIC-DISORDERS/PERIPHERAL-NERVOUS-SYSTEM-AND-MOTOR- UNIT-DISORDERS/GUILLAIN-BARR%C3%A9-SYNDROME-GBS WHO. (2016, OCTOBER 31). RETRIEVED FROM WORLD HEALTH ORGANIZATION: HTTPS://WWW.WHO.INT/NEWS-ROOM/FACT- SHEETS/DETAIL/GUILLAIN-BARR%C3%A9-SYNDROME
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