Guillain-Barre syndrome – acute idiopathic polyradiculoneuritis
Polyradiculoneuritis is an inflammatory disease that affects the nerves and evolves rapidly. The cause of Guillain-Barre is probably autoimmune, the myelin sheath of nerves being destroyed by antibodies.
Acute inflammatory demyelinating polyradiculoneuritis begins between 5 days and 3 weeks, usually after a trivial infection, surgery or a vaccine. This episode seems to trigger autoimmune polyradiculoneuritis. Among frequent infectious that are preceding Guillain-Barre syndrome are those caused by: herpes virus, enteroviruses and Campylobacter jejuni.
This type of polyradiculoneuropathy also called Guillain-Barre syndrome begins with mild muscle weakness and altered sensorium, paresthesias in the legs that extend. Muscle weakness in polyradiculoneuritis is high after 3 weeks. The clinical picture of Guillain-Barre paralysis is flaccid (soft states, without muscle tone) with abolished reflexes.
In severe cases, paralysis can achieve facial and neck muscles, the more severe is the paralysis on the respiratory muscles. In this case there is needed an urgent endotracheal intubation and mechanical ventilation. Other serious complications that occur in a small number of cases are: arrhythmias, oscillations in blood pressure, urinary retention, gastrointestinal stasis.
Evolution and treatment of acute autoimmune polyradiculoneuritis
The disease can remit within a few months or even years. Residual motor deficits may occur or after an initial improvement the polyradiculoneuritis can become chronic.
In the treatment of acute autoimmune polyradiculoneuritis the respiratory parameters should be monitored, adequate fluid intake, providing warmth, the protection of extremities from decubitus injuries or trauma, early mobilization with passive mobilization of joints (acute phase) followed by active mobilization (in remission).
Etiological and pathophysiological treatment of Guillain-Barre sybdrome is done by using plasmapheresis and administration of immunoglobulin and for chronic polyradiculoneuritis are used corticosteroids and immunosuppressants (to stop the aberrant and harmful immune answer).