Guillian-Barre syndrome

Is an acute infectious

neuronitis of the cranial and peripheral nerves.

It involves destruction of the

myelin sheath due to autoimmune disorder.

It may follow swine flu

vaccine.
It is usually preceded by

mild upper respiratory infection or gastroenteritis.

The recovery is slow process.
The main problem is DOB.

Pathophysiology
Predisposing factors:

Age Sex

Precipitating factor: Poor hygiene Post infection to Campylobacter jejuni Stress Diet Lifestyle Campylobacter jejuni

Enters the body by the use of multifenestered cells or other mechanisms Innate immune response results in the uptake of pathogens by immature antigen presenting cells

Migration of lymph nodes, a mature, differentiated antigen presenting cell can present in major histo-compatability complex molecules and activate CD4 cells that recognize antigens from the infectious pathogen

Pathogen and host have homologous or identical amino acid sequences, antigen in its capsule are shared with nerves.

B cells can be activated Th cells. This produces a cell mediated and humoral response against the pathogen. Antibodies will be produced, leading to the activation of the complement system and phagocytosis of the bacteria. Molecular mimicry
Immune response directed against the capsular components produce antibodies that cross-react with myelin Lymphocytes and macrophages circulate in the blood and eventually find myelin Lymphocytic infiltration of spinal roots and peripheral nerves, followed by macrophage mediated, multifocal stripping of myelin and axonal damage.

Defects in the propagation of electrical nerve impulses, with eventual conduction block.

Management:

Monitor respiratory status through vital capacity measurements, rate and depth of respirations, and breath sounds. Monitor level of muscle weakness as it ascends toward respiratory muscles. Watch for breathlessness while talking which is a sign of respiratory fatigue. Monitor the patient for signs of impending respiratory failure. Monitor gag reflex and swallowing ability. Position patient with the head of bed elevated to provide for maximum chest excursion. Avoid giving opioids and sedatives that may depress respirations. Position patient correctly and provide range-of-motion exercises. Provide good body alignment, range-of-motion exercises, and change of position to prevent complications such as contractures, pressure sores and dependent edema. Ensure adequate nutrition without the risk of aspiration. Encourage physical and occupational therapy exercises to help the patient regain strength during rehabilitation phase. Provide assistive devices as needed (cane or wheelchair) to maximize independence and activity. If verbal communication is possible, discuss the patients fears and concerns. Provide choices in care to give the patient a sense of control. Teach patient about breathing exercises or use of an incentive spirometer to reestablish normal breathing patterns. Instruct patient to wear good supportive and protective shoes while out of bed to prevent injuries due to weakness and paresthesia. Instruct patient to check feet routinely for injuries because trauma may go unnoticed due to sensory changes. Urge the patient to maintain normal weight because additional weight will further stress monitor function. Encourage scheduled rest periods to avoid fatigue.