Guillain-Barré syndrome: Difference between revisions

Revision as of 19:56, 14 July 2020

Background

Types

Guillain-Barré syndrome
- Acute inflammatory demyelinating polyneuropathy (AIDP)
- Acute motor axonal neuropathy
  - Acute motor-sensory axonal neuropathy
  - Acute motor-conduction-block neuropathy
  - Pharyngeal-cervical-branchial weakness
Miller Fisher syndrome
- Incomplete MFS
  - Acute motor-ophthalmoparesis, without ataxia
  - Acute ataxic neyropathy, without ophthalmoparesis
- Bickerstaff's brainstem encephalitis

Etiology

Campylobacter jejuni
Cytomegalovirus
Epstein-Barr virus
Zika virus
HIV
Non-infectious causes, including immunization, surgery, trauma, and hematopoietic stem cell transplantation

Pathophysiology

Immune crossreactivity causes autoimmune destruction of either the myelin sheath (AIDP) or the axon itself
Most common ADAM antibodies are anti-GM1 or anti-GD1a IgG, which recognize gangliosides
Most common MFS antibody is anti-GQ1b IgG (in 90%)

Epidemiology

About 1 case per 100,000 people per year in Western countries

Clinical Manifestations

Ascending paralysis ± sensory involvement
Usually occurs 1 to 2 weeks after an immune-stimulating even such as illness or vaccination
- Preceding illness usually a gastrointestinal or respiratory infection
- Campylobacter jejuni is the most common causative organism identified
- Rare following influenza vaccination; most notable was the 1976 H1N1 vaccine, with about 1 in 100,000 vaccine recipients developing GBS

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
+=== Types ===
-* Causes either acute inflammatory demyelinating polyneuropathy, or acute motor axonal neuropathy, or acute motor and sensory axonal neuropathy
+*Guillain-Barré syndrome
+**Acute inflammatory demyelinating polyneuropathy (AIDP)
+**Acute motor axonal neuropathy
+***Acute motor-sensory axonal neuropathy
+***Acute motor-conduction-block neuropathy
+***Pharyngeal-cervical-branchial weakness
+*Miller Fisher syndrome
+**Incomplete MFS
+***Acute motor-ophthalmoparesis, without ataxia
+***Acute ataxic neyropathy, without ophthalmoparesis
+**Bickerstaff's brainstem encephalitis
 ===Etiology===
@@ Line 12: / Line 24: @@
 *Non-infectious causes, including immunization, surgery, trauma, and hematopoietic stem cell transplantation
-=== Epidemiology ===
+=== Pathophysiology ===
+* Immune crossreactivity causes autoimmune destruction of either the myelin sheath (AIDP) or the axon itself
+* Most common ADAM antibodies are anti-GM1 or anti-GD1a IgG, which recognize gangliosides
+* Most common MFS antibody is anti-GQ1b IgG (in 90%)
+===Epidemiology===
-* About 1 case per 100,000 people per year in Western countries
+*About 1 case per 100,000 people per year in Western countries
-== Clinical Manifestations ==
+==Clinical Manifestations==
-* Ascending paralysis ± sensory involvement
+*Ascending paralysis ± sensory involvement
-* Usually occurs 1 to 2 weeks after an immune-stimulating even such as illness or vaccination
+*Usually occurs 1 to 2 weeks after an immune-stimulating even such as illness or vaccination
-** Preceding illness usually a gastrointestinal or respiratory infection
+**Preceding illness usually a gastrointestinal or respiratory infection
-** [[Campylobacter jejuni]] is the most common causative organism identified
+**[[Campylobacter jejuni]] is the most common causative organism identified
-** Rare following influenza vaccination; most notable was the 1976 H1N1 vaccine, with about 1 in 100,000 vaccine recipients developing GBS
+**Rare following influenza vaccination; most notable was the 1976 H1N1 vaccine, with about 1 in 100,000 vaccine recipients developing GBS
-== Further Reading ==
+==Further Reading==
-* Guillain-Barré syndrome. ''Lancet''. 2016;388:717-727. doi: [https://doi.org/10.1016/S0140-6736(16)00339-1 10.1016/S0140-6736(16)00339-1]
+*Guillain-Barré syndrome. ''Lancet''. 2016;388:717-727. doi: [https://doi.org/10.1016/S0140-6736(16)00339-1 10.1016/S0140-6736(16)00339-1]
 [[Category:Neurology]]