Guillain-Barré syndrome medical therapy: Difference between revisions
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** Immunomodulating therapy | ** Immunomodulating therapy | ||
*** Plasma exchange: It is proved in so many studies that plasma exchange is an effective treatment option and can reduce recovery time.<ref name="pmid2893583">{{cite journal |vauthors= |title=Efficiency of plasma exchange in Guillain-Barré syndrome: role of replacement fluids. French Cooperative Group on Plasma Exchange in Guillain-Barré syndrome |journal=Ann. Neurol. |volume=22 |issue=6 |pages=753–61 |date=December 1987 |pmid=2893583 |doi=10.1002/ana.410220612 |url=}}</ref><ref name="pmid1642477">{{cite journal |vauthors= |title=Plasma exchange in Guillain-Barré syndrome: one-year follow-up. French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome |journal=Ann. Neurol. |volume=32 |issue=1 |pages=94–7 |date=July 1992 |pmid=1642477 |doi=10.1002/ana.410320115 |url=}}</ref> | *** Plasma exchange: It is proved in so many studies that plasma exchange is an effective treatment option and can reduce recovery time.<ref name="pmid2893583">{{cite journal |vauthors= |title=Efficiency of plasma exchange in Guillain-Barré syndrome: role of replacement fluids. French Cooperative Group on Plasma Exchange in Guillain-Barré syndrome |journal=Ann. Neurol. |volume=22 |issue=6 |pages=753–61 |date=December 1987 |pmid=2893583 |doi=10.1002/ana.410220612 |url=}}</ref><ref name="pmid1642477">{{cite journal |vauthors= |title=Plasma exchange in Guillain-Barré syndrome: one-year follow-up. French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome |journal=Ann. Neurol. |volume=32 |issue=1 |pages=94–7 |date=July 1992 |pmid=1642477 |doi=10.1002/ana.410320115 |url=}}</ref> | ||
*** High dose immunoglobulin: IVIG is as effective as plasma exchange for treatment of GBS. Combination therapy with these two will not result in a netter outcome.<ref name="pmid1552913">{{cite journal |vauthors=van der Meché FG, Schmitz PI |title=A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. Dutch Guillain-Barré Study Group |journal=N. Engl. J. Med. |volume=326 |issue=17 |pages=1123–9 |date=April 1992 |pmid=1552913 |doi=10.1056/NEJM199204233261705 |url=}}</ref> | *** High dose immunoglobulin: IVIG is as effective as plasma exchange for treatment of GBS. Combination therapy with these two will not result in a netter outcome.<ref name="pmid1552913">{{cite journal |vauthors=van der Meché FG, Schmitz PI |title=A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. Dutch Guillain-Barré Study Group |journal=N. Engl. J. Med. |volume=326 |issue=17 |pages=1123–9 |date=April 1992 |pmid=1552913 |doi=10.1056/NEJM199204233261705 |url=}}</ref><ref name="pmid12499466">{{cite journal |vauthors=Dalakas MC |title=Mechanisms of action of IVIg and therapeutic considerations in the treatment of acute and chronic demyelinating neuropathies |journal=Neurology |volume=59 |issue=12 Suppl 6 |pages=S13–21 |date=December 2002 |pmid=12499466 |doi= |url=}}</ref> | ||
*** Corticosteroids | *** Corticosteroids | ||
Revision as of 17:07, 20 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, MBBS [2]
Overview
With prompt treatment of plasmapheresis followed by immunoglobulins and supportive care, the majority of patients will regain full functional capacity. However, death may occur if severe pulmonary complications and dysautonomia are present.
Medical Therapy
- Treatment for Guillan Barre syndrome can be divided into two groups:
- Supportive therapy:
- Respiratory assistance: WE measure maximal expiratory vital capacity and if vital capacity falls under 15 ml/kg we start mechanical ventilation and endotracheal intubation.
- Heart rate and blood pressure monitoring.
- Prevention of thromboembolic complications by heparin.
- Reduce respiratory infections by minimal sedation in intensive care units.
- Pain control by analgesics.
- Prevention of contracture by early passive movement.
- Immunomodulating therapy
- Plasma exchange: It is proved in so many studies that plasma exchange is an effective treatment option and can reduce recovery time.[1][2]
- High dose immunoglobulin: IVIG is as effective as plasma exchange for treatment of GBS. Combination therapy with these two will not result in a netter outcome.[3][4]
- Corticosteroids
- Supportive therapy:
References
- ↑ "Efficiency of plasma exchange in Guillain-Barré syndrome: role of replacement fluids. French Cooperative Group on Plasma Exchange in Guillain-Barré syndrome". Ann. Neurol. 22 (6): 753–61. December 1987. doi:10.1002/ana.410220612. PMID 2893583.
- ↑ "Plasma exchange in Guillain-Barré syndrome: one-year follow-up. French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome". Ann. Neurol. 32 (1): 94–7. July 1992. doi:10.1002/ana.410320115. PMID 1642477.
- ↑ van der Meché FG, Schmitz PI (April 1992). "A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. Dutch Guillain-Barré Study Group". N. Engl. J. Med. 326 (17): 1123–9. doi:10.1056/NEJM199204233261705. PMID 1552913.
- ↑ Dalakas MC (December 2002). "Mechanisms of action of IVIg and therapeutic considerations in the treatment of acute and chronic demyelinating neuropathies". Neurology. 59 (12 Suppl 6): S13–21. PMID 12499466.