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Sunday, November 25, 2012

MS: Guillain-Barre Syndrome



GUILLAINE-BARRE SYNDROME (GBS) – CNS disorder characterized by bilateral, symmetrical, polyneuritis leading to ascending muscle weakness/paralysis.




A.      Cause – IDIOPATHIC
B.       PREDISPOSING FACTORS
1.        Autoimmune
2.        antecedent viral infection
3.        immunizations such as your flu vaccine

C.      CLINICAL MANIFESTATION
1.        Clumsiness – initial sign
2.        Dysphagia
3.        Ascending muscle weakness à paralysis
4.        Decreased DTRs
5.        Alternate hypertension and hypotension; most feared complication: arrhythmias
6.        Autonomic changes
§  Increased sweating and lacrimation
§  Increased salivation
§  Constipation

D.      DIAGNOSTICS
1.        CSF Analysis : reveals elevated CHON and IgG
§  CSF is produced in the choroid plexus

E.       NURSING MANAGEMENT
1.        Maintain patent airway and ventilation
§  Assist in mechanical ventilation
2.        Maintain side rails (paralysis)
3.        prevent complications of immobility
4.        institute NGT feeding
5.        Administer medications as ordered
§  Anticholinergics – Atropine Sulfate
§  Corticosteroids – to suppress immune response
§  Anti-arrhythmic agents
ü  Lidocaine (Xylocaine)
ü  Bretyllium – Blocks norepinephrine
ü  Quinidines – anti-arrhythmic, anti-malarial (Malaria –king of tropical diseases kaya ang meds ay queen = quinines) Common SE: QUINCHONISM :
Q     Female anopheles – malaria, night biting, lay eggs in the morning
Q     Female aegis egyptis – dengue, day biting, lay eggs at night, 4 o’clock habit
Q     Plasmodium falciparum – most dangerous form of malaria à hemorrhage
6.        Assist in plasmaparesis
7.        Prevent complications
§  Arrhythmias
§  Respiratory Arrest


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