GULLIAN BARRE’

SYNDROME
GULLIAN BARRE’
• An inflammatory disease of unknown etiology characterized by widespread involvement
of peripheral, cranial, and spinal nerves
• A patient can recover from this syndrome

PATHOPHYSIOLOGY
• Acute patchy demyelination found in nerve roots, root ganglia, and spinal, cranial and
peripheral nerves resulting from inflammatory cells entering the perivascular spaces
• Thought to be an autoimmune response resulting from a viral infection or vaccine which
the myelin of the peripheral nerves are attacked. The myelin sheath can regenerate itself
that is why the people can recover where as with MS they cannot
• Usually follows a respiratory or gastrointestinal infection. (typically the flu)
• Will have paralysis

INCIDENCE Watch for

• Found worldwide and occurs in all seasons RESPIRATORY
• Usually affects young adults of both sexes FAILURE

MANIFESTATIONS
• Rapid occurrence of symmetrical muscle tingling and weakness usually beginning at the
feet, legs and ascending  to the trunk, arms and face producing total motor paralysis
within a few days
• If the cranial nerves become involved the person may have varying degrees of difficulty in
swallowing, speaking, breathing, and chewing.
• Pain in calf and back of legs although totally paralyzed
• Progression can cease at any stage

PROGNOSIS
• A good prognosis – If the survive the first few days
• Progression can cease at any stage
• A plateau typically occurs then improvement begins – 1-2 weeks
• Recovery is generally good with the majority of patients making a full recovery over
several months to 2 years
• About 10% are left with residual disability

DIAGNOSIS
• Made on S/S
• Lab markedly show elevated CSF protein content
 • Hx of recent viral infection
• Bels Palsy on both sides of the face
• May also do lumbar puncture
CLINICAL CARE
• A Medical Emergency
• No specific treatment
• Constant monitoring and assessment is imperative and supportive measures
• Keep near the nurses station
• During the acute phase the nurse is to provide all care for the patient
• Respiratory assistance is begun at the first sign of respiratory distress  ICU
• Respiratory insufficiency and failure may develop quickly and is the main threat to life
• Medications are not usually utilized
• Exercise and activity is restricted during the acute stage
• Provide good overall nursing care; patient is totally dependent
• Management of totally paralyzed client
o ROM, turn, proper positioning, etc
o All measures to reduce hazards of immobility
o A person’s potential for full recovery is dependent on the type of nursing care
he/she receives
• Emotional Support
• Keep anxiety very low
• Plasmapherises
o A temporary reduction in titer or circulatory antibodies works well

COMPLICATIONS
• Inadequate ventilation
• Positioning
• Suctioning
• Hazards of immobility
• Altered nutrition
• Altered elimination
• Emotional and psychological support

NURSING MANAGEMENT
• Assess respiratory and cardiac distress
• Hazards of immobility
• Rehabilitation
• Emotional Support
• Teaching
THINK RESPIRATORY
FAILURE