Guillain-Barre syndrome (acute polyradiculitis)

February 17, 2013

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Guillain Barre syndrome   (also called Acute polyradiculitis ) - this acute inflammatory polyradiculoneuropathy Which is manifested disorders of vegetative character, sluggish paresis , Violation of sensitivity.

Consequently, the man is in the disease state full   or partial immobility . Gradually, in the course of developing the disease a person loses the ability to take things hands . swallow . lifting eyelids   et al. This is a relatively rare disease. GBS   are diagnosed worldwide, and manifests itself in adults and in children. Most often it occurs in men, but no significant difference in the incidence of the disease in different sexes is not fixed.

Causes

The first to describe this disease in the 1916 . neurologists from France G. Guillain   and J. Barre , The names of which the disease was called later. But there is still no precise information about the reasons for its occurrence. Basically, the disease develops as a consequence of the previously manifested in patients with acute infection. There is an assumption that the disease provokes filter passer . Still, most experts tend to believe that Guillain Barre syndrome   It has allergic nature .

The disease is considered autoimmune process In which there is destruction of nerve tissue. Consequently, the immune system begins to " fight "With his own body and generates antibodies some molecules nerve sheath. There is damage to the nerves and nerve roots, which are located at the junction of the peripheral and central nervous systems. It is not the defeat of the brain and spinal cord. The disease begins to develop under the influence of viruses. In this case, the most commonly the disease begins with the destruction of the organism cytomegalovirus . Epstein-Barr virus As well as bacteria. Immune response to the penetration of a foreign agent develops when the body's normal state. But in some cases, failures occur in response to their own and others' cells. As a result, the immune system fights against the body.

Symptoms

Symptoms Guillain-Barre syndrome   initially manifested general weakness , and fever   and to subfebrile pain in arms and legs . Pain can also be worn shingles character. Yet the hallmark of GBS is the clear feeling of muscle weakness in the extremities . The distal, both hands and feet, are shown paresthesia In some cases they also appear around the mouth and tongue. Sometimes there is a weakness of facial muscles and other facial nerves and autonomic disorders. Violations motor nature   initially manifested in his legs, and later - and moved into his arms. Sometimes common symptom at this syndrome resembles signs myopathy .

If development Guillain-Barre syndrome   marked nerve damage bulbar group Then without timely respiratory resuscitation people may die.

Pronounced as violations of vegetative character Which appear chilliness and coldness distal extremities, a phenomenon hyperhidrosis . In severe disease development is sometimes observed violation of pelvic functions, manifested urinary retention. This symptom usually lasts from 3 to 5 days .

Acute polyradiculitis Typically develops over two to four weeks, after which the human condition is stabilized, and improvement occurs. Not only diagnoses acute form of the disease , but also subacute , and chronic . In most cases, it is a favorable prognosis, but sometimes the disease develops by type ascending Landry's paralysis Where paralysis   cover arm muscles . trunk   and bulbar muscles .

Diagnostics

To the outcome was favorable, it is important to recognize the illness in its early stages and a timely start of his therapy. Initially, the expert must perform a detailed inquiry, during which determines how there was an increase of symptoms, which is manifested signs. An important criterion for diagnosis Guillain Barre syndrome   considered muscle weakness in the hands and / or feet Having a progressive character, and tendinous areflexia .

The doctor notes the symmetry sure defeat, violations of sensitivity, cranial nerves, autonomic disorders. The important point is the lack of fever   in the early days of the disease. The diagnostic process is important to determine the presence of a typical protein-cell dissociation in the cerebrospinal fluid. During the puncture, there is a high concentration of protein.

Polyradiculoneuritis Guillain   ( Guillain-Barre ) Has some features similar to symptoms of other diseases. It is important to distinguish symptoms from Botulism . myasthenia . paralysis Which arises as a consequence of receiving antibiotics . It is also important to differentiate the disease with lesions of the spinal cord and brain stem, transverse myelitis . porfiriynoy polyneuropathy   and others. For this purpose, conducted laboratory studies, appoint additional methods of examination of the patient. In particular, in cases of suspected GBS   A study the composition of cerebrospinal fluid . rheotachygraphy . If cerebrospinal fluid is a high level of protein after the first week of the disease or its content increases, and later we can talk about suspected Guillain Barre syndrome . It also investigates the features of cell composition.

Treatment

Treatment disease Guillain-Barre   held immediately after diagnosis. An effective method of treatment is considered to be plasmapheresis   with intravenous administration immunoglobulin . Patients GBS   partially removed blood plasma , Formed elements in this return. Also, during treatment practiced reception glucocorticoids   (especially for patients assigned prednisolone   1-2 mg / kg per day) antihistamines   ( suprastin . diphenhydramine ), Reception vitamins   (mainly Group B ). Also in the complex treatment includes reception anticholinesterase drugs   ( neostigmine . galantamine ).

During therapy, it is important to provide high-quality patient care And continually monitor its function Cardiovascular   and respiratory systems . After all, with severe disease can occur very quickly respiratory failure, and in the absence of prompt treatment may be fatal. With a decrease in lung capacity, or is in bulbar syndromes are urgently needed Intubation   or tracheotomy , to provide ventilatory . In the process of patient care should be at least once every two hours carefully turn the patient in bed.

If the patient has symptoms hypertension , and tachycardia , The attacks must be removed with the help of antagonists of calcium ions   and beta-blockers . To avoid raising the blood pressure practiced by administering fluids intravenously to enlarge intravascular volume .

If he is observed acute urinary retention Then as a result of reflex disorders can vary the pulse and blood pressure. With this development of the disease is necessary to use an indwelling catheter.

It is equally important to provide quality rehabilitation therapy at a time when the human condition is improving. At this time, the patient shows physiotherapy . ozokerite . massage . paraffin   and etc.

If we talk about the forecasts, it is restoring normal health with no serious effects were observed in approximately 80% of people Who was diagnosed polyneuropathy, Guillain-Barre syndrome . However, please note that in severe disease recovery will also be longer and more complex. Patients recover completely and live life to the fullest. Yet lifetime recover from GBS   People may feel a little weak in the arms and legs.

The severity of the disease depends on the presence or absence of residual effects. Sometimes the recovery is about 1, 5-2 years . But it happens, and so that the recovery does not occur, and then the person is completely dependent on the help of others. This picture is about 5-8% of the cases of GBS . According to various sources, mortality due to the disease can range from 1 to 18%. Most people die as a result of bronchopneumonia   and respiratory distress syndrome .