Acute Inflammatory Polyneuropathy (Guillain-Barré Syndrome)

  • Ernst F. Hund
  • Volker Schuchardt
  • Allan H. Ropper
  • Daniel F. Hanley

Abstract

Acute inflammatory polyneuropathy, or Guillain-Barré syndrome (GBS), is an acutely or subacutely paralyzing disorder which typically has a monophasic course and remits spontaneously. Weakness is thought to result from an immune-mediated inflammation of the peripheral nerves, leading to disruption of the surrounding myelin and secondary axonal loss. The incidence of GBS is roughly the same throughout the world, with approximately 1.0–1.5 cases per 100 000 persons per year and a possible slight preponderance for males. Most cases follow an infection. The clinical core features include a relatively symmetric muscle weakness, areflexia, and distal paresthesias. The diagnosis is usually confirmed by a characteristic spinal fluid formula of raised protein with no or few cells, and by electrodiagnostic findings indicative of demyelination. Respiratory failure due to weakness of the diaphragm and cardiovascular instability due to autonomic dysfunction are the main reasons for intensive care. After admission to the ICU, most serious complications result from mechanical ventilation, hemodynamic or cardiac disturbances, venous thrombosis, or sepsis. This chapter focuses on the management and treatment of severe GBS, emphasizing the skilled nursing and medical care required to reduce morbidity and mortality in this fundamentally self-limited disease.

Keywords

Fatigue Influenza Heparin Morphine Meningitis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • Ernst F. Hund
  • Volker Schuchardt
  • Allan H. Ropper
  • Daniel F. Hanley

There are no affiliations available

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