Guillain-Barre Syndrome

Raquel Benhayoun
Amaya Rodriguez
Yohanna Vazquez
Clinical Case

• A 20-year-old woman with no significant past medical history

presents with lower back pain and bilateral foot and hand tingling.
Her symptoms rapidly progress over 4 days to include lower
extremity weakness to the point that she is unable to mobilize her
lower extremities. She reports coryzal symptoms 2 weeks ago.. On
examination, she has 0/5 power in her lower extremity with
areflexia, but despite the paresthesia's she does not have sensory
deficits.
Pathophysiology

Infection Demyelination & Symmetric

Slow Nerve
Axonal Weakness &
(Viral/Bacterial) Impulses
Degeneration Paresthesia's
Etiology

• GBS is characterized by an immune-mediated attack on the myelin sheath or

Schwann cells of sensory and motor nerves.
• Viral or bacterial infections (Campylobacter jejuni, cytomegalovirus)
• Immunizations
• Zika virus outbreaks
Epidemiology (statistics and demographics)

• Western hemisphere with no clustering or major seasonal

variations
• Demyelinating neuropathy is most common in Western Countries
(80%-90%)
• Ages between 2 and 95 years old, usually not common in infants
• More common in Males
• Acute motor axonal neuropathy is more common in Japan and
China
Signs & Symptoms

• Muscle Weakness (usually ascending

pattern)
• Respiratory distress
• Speech problems
• Paresthesia’s (pins and needles)
• Back & leg pain
• Facial weakness
Treatment

• Best option: plasma exchange

• Supportive treatment:
• Vital signs monitoring
• Deep vein thrombosis prevention with medications
• Pain management- gabapentin or carbamazepine
Treatment-Physical Therapy
Approach

• Physical Therapy
• Rehabilitation program
• Exercises
• Proprioceptive neuromuscular
facilitation
• Areas of Focus:
• Joint Range of Motion
• Muscle Strengthening
• Mobility
• Education & training (DVT
prevention, bed sores,
positioning)
Prognosis/Complications

• Prognosis:
• 60% of patients will recover within 1 year
• Permanent disability is not very common (10%-20%)
• Hold immunizations within the first year
• Complications:
• Fatigue
• Respiratory failure
• Bladder problems
 References

• Guillain-Barre Syndrome. (n.d.). Retrieved from

https://online.epocrates.com/diseases/17624/Guillain-Barre-syndrome

• McNamara, D. (2020, April 29). Two Rare Neurologic Conditions Linked to COVID-19.
Retrieved September 22, 2020, from https://www.medscape.com/viewarticle/929631
• Sawant, P., & Ferzandi, Z. (2015). Effect of Occupational Therapy on Fatigue and Quality of
Life in Patients with Guillain Barre Syndrome. Indian Journal of Physiotherapy &
Occupational Therapy, 9(4), 209–215. https://doi.org/10.5958/0973-5674.2015.00174.4
• Simatos Arsenault, N., Vincent, P. O., Yu, B. H., Bastien, R., & Sweeney, A. (2016). Influence
of Exercise on Patients with Guillain-Barré Syndrome: A Systematic Review. Physiotherapy
Canada. Physiotherapie Canada, 68(4), 367–376. https://doi.org/10.3138/ptc.2015-58
 References

• Sharma, V., Kaur, H., Malhotra, L. K., & Sairam, N. (2015). GBS following Tumour
Excision:
Physiotherapy Management. Indian Journal of Physiotherapy & Occupational Therapy, 9(1), 20–24.
https://doi.org/10.5958/0973-5674.2015.00005.2
• Teodoro, T., Oliveira, R., & Afonso, P. (2019). Atypical Lyme Neuroborreliosis,
Guillain-Barre
Syndrome or Conversion Disorder: Differential Diagnosis of Unusual Neurological Presentations. Case
Reports in Neurology, 11(1), 142+.
https://link.gale.com/apps/doc/A593431291/HRCA?u=lincclin_mdcc&sid=HRCA&xid=ce4c0fc2
• Vidhyadhari, B. S. L., & Madavi, K. (2015). Influence of Proprioceptive Neuromuscular
Facilitation Techniques on Diaphragm Muscle Activity and Pulmonary Function in Subjects with
Guillain - Barre Syndrome. Indian Journal of Physiotherapy & Occupational Therapy, 9(2), 24–28.
https://doi.org/10.5958/0973-5674.2015.00047.7