Guillain-Barré syndrome history and symptoms: Difference between revisions
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*** It causes areflexia | *** It causes areflexia | ||
*** In AIDP we may see autonomic involvement such as changes in heart rate and blood pressure and urinary retention. | *** In AIDP we may see autonomic involvement such as changes in heart rate and blood pressure and urinary retention. | ||
** Acute motor axonal neuropathy/Acute motor and sensory axonal neuropathy: | ** Acute motor axonal neuropathy/Acute motor and sensory axonal neuropathy:<ref name="pmid">{{cite journal |vauthors=Kuwabara S, Ogawara K, Koga M, Mori M, Hattori T, Yuki N |title=Hyperreflexia in Guillain-Barré syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody |journal=J. Neurol. Neurosurg. Psychiatry |volume=67 |issue=2 |pages=180–4 |date=August 1999 |pmid= |pmc=1736477 |doi= |url=}}</ref> | ||
*** Can causes hyperreflexia. | *** Can causes hyperreflexia. | ||
*** Autonomic dysfunction in absent or mild. | *** Autonomic dysfunction in absent or mild. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, MBBS [2]
Overview
Patient may present with an antecedence of mild infection of respiratory or gastrointestinal infections that may disappear before the onset of weakness. Many patients also give a history of pins and needles sensation before the onset of weakness of limbs. Symmetrical, bilateral, weakness of lower limbs followed by upper limb, trunk and cranial nerve may be seen. Sensory symptoms are usually mild and patients may complain of decreased or increased pain sensation, decreased touch and difficulty walking (loss of position sense) depending on stage and type of GBS. Autonomic involvement in form of urinary retention, constipation and awareness of own's heartbeat can be found. Cranial nerve involvement in form of blurred vision, facial drooping, difficulty in swallowing and speaking can be seen.
History and Symptoms
History
- Patients may present with a history of antecedence benign infection of gut or respiratory tract, 2-4 weeks prior to the development of symptoms [1]. However, these infections usually resolve before onset of weakness.
- Symptoms can get worse very quickly. It may take only a few hours to reach the most severe symptoms, however weakness increasing over several days is also common.
- The mean time to the clinical function peak is 2 weeks, with most of the patients reaching a nadir by 4 weeks.
- This is usually followed by a plateau phase characterized by persistent, unchanging symptoms.
- The plateau phase may last for days before initiation of gradual symptoms improvement [2].
- Recovery usually starts 2-4 weeks after the progression of symptoms ceases [3].
- The mean time to clinical recovery is 15-20 weeks
Common symptoms
- Most of Guillain Barre syndrome cases can be diagnosed based on partially symmetrical ascending weakness and paralysis.
- Can cause sensory symptoms such as tingling and paresthesia.[4]
- Because of nerve inflammation, in the acute phase of GBS patients complain of pain.[5]
- Some of the features may be specific to different subgroups of GBS.
- Acute inflammatory demyelinating polyneuropathy:(4)
- It affects lower extremities first and then involves upper extremities, trunk, neck and cranial nerves.
- It can involve sensory neurons.
- Deep sensation is the most affected sense.
- It causes areflexia
- In AIDP we may see autonomic involvement such as changes in heart rate and blood pressure and urinary retention.
- Acute motor axonal neuropathy/Acute motor and sensory axonal neuropathy:[6]
- Can causes hyperreflexia.
- Autonomic dysfunction in absent or mild.
- AMSAN can causes severe type of GBS with slow recovery
- Miller Fisher syndrome[7]
- This type of GBS causes ophthalmoplegia.
- The reflexes are absence.
- There is gait abnormalities (Ataxia).
- Acute inflammatory demyelinating polyneuropathy:(4)
Less Common Symptoms
- Papilledema[8]
- Facial myokymia[9]
- Hearing loss[10]
- Vocal cord paralysis[11]
- Mental status changes[12]
References
- ↑ Nelson L, Gormley R, Riddle MS, Tribble DR, Porter CK (2009). "The epidemiology of Guillain-Barré Syndrome in U.S. military personnel: a case-control study". BMC Research Notes. 2: 171. doi:10.1186/1756-0500-2-171. PMC 2739856. PMID 19709434. Retrieved 2012-02-23.
- ↑ Hughes RA, Rees JH (1997). "Clinical and epidemiologic features of Guillain-Barré syndrome". The Journal of Infectious Diseases. 176 Suppl 2: S92–8. PMID 9396689. Retrieved 2012-02-23. Unknown parameter
|month=ignored (help) - ↑ El Mhandi L, Calmels P, Camdessanché JP, Gautheron V, Féasson L (2007). "Muscle strength recovery in treated Guillain-Barré syndrome: a prospective study for the first 18 months after onset". American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 86 (9): 716–24. doi:10.1097/PHM.0b013e31813e0b67. PMID 17709995. Retrieved 2012-02-23. Unknown parameter
|month=ignored (help) - ↑ Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.
- ↑ Moulin DE, Hagen N, Feasby TE, Amireh R, Hahn A (February 1997). "Pain in Guillain-Barré syndrome". Neurology. 48 (2): 328–31. PMID 9040715.
- ↑ Kuwabara S, Ogawara K, Koga M, Mori M, Hattori T, Yuki N (August 1999). "Hyperreflexia in Guillain-Barré syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody". J. Neurol. Neurosurg. Psychiatry. 67 (2): 180–4. PMC 1736477.
- ↑ Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T (April 2001). "Clinical features and prognosis of Miller Fisher syndrome". Neurology. 56 (8): 1104–6. PMID 11320188.
- ↑ JOYNT RJ (January 1958). "Mechanism of production of papilledema in the Guillain-Barre syndrome". Neurology. 8 (1): 8–12. PMID 13493684.
- ↑ Mateer JE, Gutmann L, McComas CF (March 1983). "Myokymia in Guillain-Barré syndrome". Neurology. 33 (3): 374–6. PMID 6681885.
- ↑ Nelson KR, Gilmore RL, Massey A (August 1988). "Acoustic nerve conduction abnormalities in Guillain-Barré syndrome". Neurology. 38 (8): 1263–6. PMID 3399076.
- ↑ Panosian MS, Quatela VC (February 1993). "Guillain-Barré syndrome presenting as acute bilateral vocal cord paralysis". Otolaryngol Head Neck Surg. 108 (2): 171–3. doi:10.1177/019459989310800211. PMID 8441543.
- ↑ Cochen V, Arnulf I, Demeret S, Neulat ML, Gourlet V, Drouot X, Moutereau S, Derenne JP, Similowski T, Willer JC, Pierrot-Deseiligny C, Bolgert F (November 2005). "Vivid dreams, hallucinations, psychosis and REM sleep in Guillain-Barré syndrome". Brain. 128 (Pt 11): 2535–45. doi:10.1093/brain/awh585. PMID 16000335.