Guillain-Barré syndrome history and symptoms: Difference between revisions
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* Patients generally notice weakness in their legs, manifesting as "rubbery legs" or legs that tend to buckle | * Patients generally notice weakness in their legs, manifesting as "rubbery legs" or legs that tend to buckle | ||
* The progression of symptoms may take hours to days. Depending on the type of GBS involvement of sensory, repiratory and autonomic system may occur. | * The progression of symptoms may take hours to days. Depending on the type of GBS involvement of sensory, repiratory and autonomic system may occur. | ||
* Difficulty in swallowing, drooling, and respiratory difficulties may be if cranial nerves are affected. Most patients require hospitalization and about 30% require ventilatory assistance. | |||
* Eye movement abnormalities are not commonly seen in ascending GBS, but are a prominent feature in the Miller-Fisher variant | * Eye movement abnormalities are not commonly seen in ascending GBS, but are a prominent feature in the Miller-Fisher variant | ||
* Facial weakness is also commonly a feature. | * Facial weakness is also commonly a feature. | ||
Revision as of 15:23, 23 February 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]
Overview
Guillain-Barré syndrome (GBS) is an acute, autoimmune, polyradiculoneuropathy affecting the peripheral nervous system, usually triggered by an acute infectious process. It is included in the wider group of peripheral neuropathies. There are several types of GBS, but unless otherwise stated, GBS refers to the most common form, acute inflammatory demyelinating polyneuropathy (AIDP). It is frequently severe and usually exhibits as an ascending paralysis noted by weakness in the legs that spreads to the upper limbs and the face along with complete loss of deep tendon reflexes. However, death may occur if severe pulmonary complications and dysautonomia are present.
History and symptoms
History
- Patients with Guillain-Barre syndrome may present with a history of antecedence benign infection of gut or respiratory tract, 2-4 weeks prior to the development of symptoms.
- The mean time to the clinical function nadir is 12 days, with 98% of patients reaching a nadir by 4 weeks. This is followed by a plateau phase characterized by persistent, unchanging symptoms. The plateau phase may last for days before initiation of gradual symptoms improvement.
- Recovery usually starts 2-4 weeks after the progression of symptoms ceases.
- The mean time to clinical recovery is 15-20 weeks
Symptoms
- The first neurological symptoms in many patient may be tingling or numbness sensation of the fingers.
- These symptoms may be followed by development of weakness which affects the lower limbs first, and rapidly progresses in an ascending fashion to involve trunk, upper limb and facial muscle, and other parts of the body usually over periods of hours to days.
- Patients generally notice weakness in their legs, manifesting as "rubbery legs" or legs that tend to buckle
- The progression of symptoms may take hours to days. Depending on the type of GBS involvement of sensory, repiratory and autonomic system may occur.
- Difficulty in swallowing, drooling, and respiratory difficulties may be if cranial nerves are affected. Most patients require hospitalization and about 30% require ventilatory assistance.
- Eye movement abnormalities are not commonly seen in ascending GBS, but are a prominent feature in the Miller-Fisher variant
- Facial weakness is also commonly a feature.
- Loss of position sense, pain and temperature sensation may present if sensory system is involved. Loss of pain and temperature sensation is usually mild. In fact, pain is a common symptom in GBS, presenting as deep aching pain usually in the weakened muscles, which patients compare to the pain from overexercising.
- Problems in urination can be there.
- Fever is uncommon and, and if it ispresent, another cause should be suspected.
- Dizziness on standing from sitting or lying position (orthostatic hypotension) and racing heart can be also presented (autonomic involvement)
Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts in the legs and then spreads to the arms. This is called ascending paralysis.
Patients may notice tingling, foot or hand pain, and clumsiness. If the inflammation affects the nerves to the diaphragm, and there is weakness in those muscles, the person may need breathing assistance.
Typical symptoms include:
- Loss of reflexes in the arms and legs
- Muscle weakness or loss of muscle function (paralysis)
- Numbness, decreased sensation
- Sensation changes
- Tenderness or muscle pain (may be a cramp-like pain)
- Uncoordinated movement
Additional symptoms may include:
- Blurred vision
- Clumsiness and falling
- Difficulty moving face muscles
- Muscle contractions
- Palpitations (sensation of feeling heartbeat)
Emergency symptoms (seek immediate medical help):
- Breathing temporarily stops
- Can't take a deep breath
- Difficulty breathing
- Difficulty swallowing
- Drooling
- Fainting
- Feeling light-headed when standing