Guillain-

Barre
Syndrome
Dimaocor, Zainab T.
Dimaporo, Alaisah S.
Dimaporo, Jannah Marie A.
 Introduction
Autoimmune disorders occur
when the immune system
malfunctions and attacks the
body’s own tissues and organs.
 01
Guillain-
Barre
Syndrome
Guillain-Barre syndrome is an autoimmune disorder
that affects the nerves. The immune response
damages peripheral nerves which are the nerves that
connect to the central nervous system to the limbs and
organs.
 Can affect the neurons that:
Control muscle movement
01

Transmit sensory signals

such as pain, temperature, 02
and touch

Control involuntary
functions of the body like 03
blood pressure and heart rate
(occasionally)
 Symptoms of the Disease
01 02
Muscle Dyspnea
weakness or Difficulty breathing

paralysis
The weakness often begins
in the legs and spreads to the
arms, torso, and face; often 03
accompanied by numbness,
tingling, or pain. Dysphagi
Difficulty a
swallowing
 Types
Acute Inflammatory Acute Motor
Demyelinating Axonal
Polyradiculoneurop Neuropathy
athy

Acute Motor- Miller Fisher

Sensory Axonal syndrome
Neuropathy
 Acute Inflammatory
Demyelinating
Polyradiculoneuropathy
The most common type of Guillain-Barré syndrome is acute inflammatory
demyelinating polyradiculoneuropathy (AIDP). In AIDP, the immune response
damages myelin, which is the covering that protects axons and promotes the
efficient transmission of nerve impulses.
 Acute Motor Axonal
Neuropathy
In AMAN, only the axons of motor neurons are damaged.

Acute Motor-Sensory
Axonal Neuropathy
In AMSAN, the axons of sensory neurons are also damaged. Because of sensory
nerve damage, affected individuals can lose the ability to sense the position of their
limbs and can have abnormal or absent reflexes (areflexia).
 Miller Fisher
Syndrome
Another type of Guillain-Barré syndrome, involves cranial nerves, which extend
from the brain to various areas of the head and neck. Miller Fisher syndrome is
characterized by three features: weakness or paralysis of the muscles that move the
eyes (ophthalmoplegia), problems with balance and coordination (ataxia), and
areflexia. People with this condition can have other signs and symptoms common
in Guillain-Barré syndrome, such as muscle weakness.
 02
Etiology
The exact cause of Guillain-Barre syndrome isn't
known. The disorder usually appears days or weeks
after a respiratory or digestive tract infection. Rarely,
recent surgery or vaccination can trigger Guillain-
Barre syndrome. Recently, there have been cases
reported following infection with the Zika virus.
 AMAN &
AMSAN
Prevalence
3 to 5%
Miller Fisher The prevalence of
<5% Guillain-Barré
syndrome is
estimated to be 6 to
40 cases per 1 million
people
AIDP
90%
Miller Fisher
Approx. 20%

AMAN &
AMSAN
30 to 50%
Incidence
Most studies show annual incidence figures
similar to those in the United States,
without geographical clustering. AMAN
and AMSAN occur mainly in northern
China, Japan, and Mexico, making up only
5-10% percent of GBS cases in the United
States. AIDP accounts for up to 90% of
cases in Europe, North America, and the
developed world.
Risk Factor
Age
Guillain-Barre syndrome
can affect all age groups.
But your risk increases
as you age.

Gender
Guillain-Barre syndrome
is more common in men
than in women.
 Guillain-Barre syndrome may be
Infection triggered by:
with
Influenza Cytomegalovi Epstein-
camplyobact rus
virus Barr virus
er
A type of bacteria found
in undercooked poultry

Mycoplasm
Hepatitis A,
Zika virus HIV a
B, C, and E
pneumonia
 Guillain-Barre syndrome may be
triggered by: Influenza
Hodgkin’s or
Surgery Trauma lymphoma childhood
vaccination
s

COVID-19
infection
 03
Pathophysiolo
gy
 04
Clinical
Manifestatio
n
 Clinical Manifestation

Often begins Ascending Pain

with the lower muscle Mostly on shoulders, back,
limbs weakness
Proximal muscle weakness
very frequent, especially
and thighs

initially, with subsequent

distal arm and leg weakness​
 Clinical Manifestation

Reduced or Symmetric Sensory

absent reflexes paresthesia disturbance
Areflexia or hyporeflexia
 Clinical Manifestation

Facial and Cranial nerves Respiratory

oropharyngeal 3-7 and 9-12 inadequacy
weakness affected Possible respiratory failure

Facial palsy, diplopia,

dysarthia, dysphagia,
ophthalmoplagia
Clinical Manifestation

Altered mental ANS

status dysfunction
Urinary retention, cardiac
arrhythmias, sinus
tachycardia
 05
Diagnostic
Evaluation
 Concepts and Typology

01 02 03
EMG & nerve
History and Diagnostic
conduction
physical criteria
● testblock,
examination Progressive, symmetric
weakness of <1 limb
Conduction
decreased F-wave, Sural
● Hyporeflexia/areflexia sparing
● Symmetric weakness
 Concepts and Typology

04 05 06
Lumbar
Chest x-ray MRI
puncture
“Albuminocytologic
dissociation”
- Normal WBC
- Elevated CSF
protein
These findings may not be
present in all.
 06
Nursing
Diagnoses
 Nursing Diagnoses
● Ineffective Breathing Pattern
● Acute Pain
● Impaired Physical Mobility
● Impaired Urinary Elimination
● Anxiety
 07
Principles of
Therapeutic
Management of
Inflammatory and
Immunologic
Disorders
 Nursing Management
● Assess motor strength or functional level of
mobility​
● Monitor nutritional needs as they associate
with immobility​
● Place the client in a position of comfort.
Provide frequent position changes as
tolerated​
● Provide padding to bony ​
● Assess level of pain and ability to engage in
activities prominences such as elbow and
heels.​
● Perform active, passive and isotonic range
of motion exercises as appropriate​
● Evaluate the need for assistive devices and
provide a safe environment.
● Monitor intake and output every 4 to 8
hours and palpate bladder every 2 hours;
assess for cloudy, foul-smelling urine​
● Instruct to report any reduction or
absence of urinary elimination.​
● Assist client in urinary elimination
rehabilitation program​
● Assess oxygen saturation and review
client’s arterial blood gases result​
● Keep the head of bed elevated at around
35-45° to Increases lung expansion and
cough effort minimizes the work of
breathing and the risk of aspiration of
secretions​.
 Drug Therapy
Plasma Exchange
- (PE)
Also known as plasmapheresis
- A catheter is inserted into the
patient’s veins in which some
blood is removed. The blood
cells from the plasma are
extracted and returned to the
patient.
- Seems to reduce the severity and
duration of GBS.
- Removes by removing the bad
antibodies that have been
damaging the nerves
Immunoglobulin Therapy
(IVIg)
- Intravenous injections of
immunoglobulins which are
developed from a pool of
thousand donors.
- The result of IVIg can lessen the
immune attack on the nervous
system and shorten recovery
time.
- Lowers the effectiveness of the
antibodies that are attacking the
nerves by “diluting” them with
non-specific antibodies.
Plasma Exchange (PE) Nursing
Interventions
- Adverse effects of PE include allergic reactions, hypotension and
hypocalcemia which might result in discontinuation of treatment in some
cases
- Hypotension: Place feet above heart, increase fluid intake, using
compression stockings, avoid standing for a long time
- Hypocalcium: Prevent falls, administer IV calcium as ordered or oral
calcium with Vitamin D supplements, and encourage intake of foods
high in Calcium
Immunoglobulin Therapy (IVIg) Nursing
Intervention
- IVIg is generally tolerated well and has mild side effects which are mostly related to
infusion rate (including headaches, nausea, vomiting, chills and fever, back pain and
fatigue). However, it could be accompanied with serious side effects including thrombotic
events, anaphylaxis, and renal impairment.
- Acute pain (headache and back pain): Administer analgesics as ordered, provide
nonpharmalogic pain management (distraction, massage, heat and cold applications, etc).
- Nausea and vomiting: Provide an emesis bin within easy reach, eliminate strong odors
from surroundings, maintain fluid balance, introduce cold water, ice chips, ginger products,
and room temperature broth if tolerated and appropriate for patient’s diet, administer
antiemetics as ordered, etc.
- Fever: Adjust environmental factors, eliminate excess clothing/cover, administer
antipyretics as ordered, encourage fluid intake, perform tepid sponge bath, etc.
 Surgical
Management
There is no available surgical management for
Guillain-Barre Syndrome.
 Complications
Residual Heart and
Breathing numbness & blood
Nerve pain other pressure
difficulties
sensations problems

Bowel and
bladder Pressure
Blood clots Relapse
function sores
problems
Prevention of Complications
● Nerve pain
○ One-third of patients experience nerve pain, which can be treated with medication
● Breathing problems
○ Up to 22% of patients need help from a machine to breath within the first week that they are hospitalized
● Residual numbness and other sensations
○ Most people recover quickly or experience minor residual weakness, numbness, or tingling
● Heart and blood pressure problems
○ Constant monitoring of blood pressure and heart rate.
● Bowel and bladder function problems
● Blood clots
○ Immobile patient are more at risk.
○ Taking blood thinners and wearing support stocking
● Pressure sores
○ Immobile patients are more at risk
○ Frequent repositioning
● Relapse
○ 2-5% of people with GBS experience relapse
 05
Prognosis
“The overall prognosis of GBS is quite good
with approximately 85% of survivors making
a good functional recovery.”

—M. Koc, N. Ozalp, and

B. Zulfikaroglu (2002)
 60-
4-7%
Mortality
rate 80%
Patients are able to
walk at 6 months
 5-
60%
Attain full recovery
of motor strength
10%
Prolonged recovery
with several months
after one year of ventilator
dependency.
END
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%20(gee%2DYAH,eventually%20paralyzing%20your%20whole%20body

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