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🔔The pathophysiologic mechanism of an antecedent illness and of GBS can be typified by Campylobacter jejuni infections.The virulence of C jejuni is thought to be based on the presence of specific antigens in its capsule that are shared with nerves.
🔔Cytomegalovirus (CMV) infections are the second most commonly reported infections preceding GBS, with CMV being the most common viral trigger of GBS
🌚 Evidence exists that coronavirus disease 2019 (COVID-19) is linked to the development of neurologic complications, including GBS.
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🔥🔥Acute post infectious polyneuropathy (Guillian Barre syndrome) 🔥🔥:
can be described as a collection of clinical syndromes that manifests as an acute inflammatory polyradiculoneuropathy( Auto immune demyelinating polyneuropathy) with resultant weakness and diminished reflexes.
📌The typical patient with GBS, which in most cases will manifest as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), presents 2-4 weeks following a relatively benign respiratory or gastrointestinal illness with complaints of dysesthesias and proximal muscle weakness of the lower extremities. The weakness may progress over hours to days to involve the arms, truncal muscles, cranial nerves, and muscles of respiration.
It is affecting all ages( common at 3-12 yr).
🌼Clinical picture :
📌Motor :acute ascending flaccid paralysis :
Bilateral & symmetric usually. Associated hyptonia & hyporeflexia even in uninvolved muscles.
✔Progress: -Lower Limb 🔜 trunk 🔜upper limb🔜Bulbar palsy 🔜 dysphonia, dysphagia & lost bulbar reflexes. 🔜Respiratory muscles 🔜 respiratory failure.
📌Sensory : mild; Most patients complain of paresthesias, numbness, or similar sensory changes. Loss of vibration, proprioception, touch, and pain distally may be present.
📌Autonomic : labile blood pressure & heart rate , urinary retention ,constipation ,..
🌼Diagnosis:
1- CSF : (Cytoalbuminous dissociation) Most, but not all, patients with GBS have an elevated cerebrospinal fluid (CSF) protein level (>400 mg/L), with normal CSF cell counts. Elevated or rising protein levels on serial lumbar punctures and 10 or fewer mononuclear cells/mm3 strongly support the diagnosis
2- ⬇Nerve conduction velocity (may be normal in early stage).
🌼 Treatment :
✔Admission to the intensive care unit (ICU) should be considered for all patients with labile dysautonomia, a forced vital capacity of less than 20 mL/kg, or severe bulbar palsy.Any patients exhibiting clinical signs of respiratory compromise to any degree also should be admitted to an ICU.
💊Supportive: Hospitalization and ،Cardiac monitoring ، Respiratory support ، Nasogastric feeding ،Care of bladder (catheterization & neostigmine),Physiotherapy.
💊Specific : Intravenous immunoglobulin (IVIG): 0.4 mg /kg/day for 5 days.
Alternatives: Plasmapharesis is equally effective as IVIG.
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