Guillain Barre Syndrome

Guillain Barre Syndrome is a serious disorder that occurs when the body defense system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness.

There are 6 different subtypes of GBS and they are:

  • Acute inflammatory demyelinated polyneuropathy
  • Miller fisher syndrome
  • Acute motor axonal neuropathy
  • Acute motor sensory axonal neuropathy
  • Acute panautonomic neuropathy
  • Bickerstaff’s brainstem encephalitis

Aetiology:

  • Autoimmune
  • Bacteria (campylobacter, jejuni, mycoplasma pneumonia)
  • Virus (for Zika virus, cytomegalovirus, Epstein Barr virus, varicella zoster virus)
  • Idiopathic factor
  • Vaccines (influenza vaccine, rabies vaccine)

Signs and symptoms:

  • Muscle weakness
  • Numbness
  • Loss of reflexes on arms and legs
  • Low blood pressure
  • Uncoordinated movement
  • Facial weakness
  • Clumsiness and falling
  • Severe pain in the lower back
  • Sensation changes
  • Tenderness or muscle pain
  • Blurred vision
  • Respiratory problems

What is your patient feeling?

In order to maximize the impact of your Plan of Care on your patient’s prognosis, it is important to understand that their emotions frequently will override reason.

Evaluation:

  • Patient/Caregiver Interview
  • Sensory Assessment
  • Skin Inspection
  • Joint range of motion
  • Muscle testing
  • Functional testing
  • Mobility
  • Other, respiration, DVT, Endurance, Autonomic Dysfunction

 

Medical management:

Patients with GBS will be hospitalized initially (medical emergency). It is important to monitor the individual’s respiration carefully. If breathing problems are severe he/she may be placed in an ICU and put on a ventilator.

According to the National Health Service, the two main initial treatment options for GBS are intravenous immunoglobulin, which is safer and easier to give, or plasmapheresis (plasma changes)

Treatment;

The principal goals of Occupational Therapy are to:

  • Help the patient to achieve optimal muscle use at a tolerable pain level as nerve supply returns; and
  • Use supportive equipment and other functional adaptations to help patients with residual impairments to resume an activity level that is as close to their previous lifestyle as possible.

Therapy does not facilitate nerve repair; however, it does help the recovering patient to learn optimal use of muscles as the nerves heal and innervation improves. Every person with GBS, CIDP or variants responds differently to the physical manifestations of his or her condition as well as pharmaceutical and therapeutic/ rehabilitation interventions. Consequently, it is essential to keep in mind that the body only will do what it is capable physically of doing, regardless of the expectations of the patient or therapy staff. Use a ‘safety first’ approach by teaching your patient to perform only activities he or she can do safely.

In Conclusion:

Physical and occupational therapy are integral parts of the recovery and management of GBS and variants.  Their proper utilization can help a patient minimize pain, increase strength and endurance and prevent secondary complications and overuse damage to muscles and joints while improving balance and mobility and restoring functional activity at home, work and play. If you or your patient has additional questions regarding GBS, CIDP or variants, please contact the Foundation directly or visit our website at www.gbs-cidp.org. In many instances, one of our local contacts will be available to visit personally with your patient and provide support to them and their caregivers.

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