Disease: Etiology:
Guillan-Barre Autoimmune - Exact
Syndrome cause unknown
Populations,  Only about one person in 100,000
 Most common form in the U.S. is
Prevalence, Acute Inflammatory
Incidence Demyelinating
polyradiculoneuropathy (AIDP)
 Affects all age groups; young-
Risk Factors
adult men have a slightly higher
risk for contracting it.
 It is often preceded by an
Transmission
infectious illness such as a
respiratory infection or the
stomach flu.
 It is not contagious.
Genetics  Multiple genetic and
environmental factors likely play
a part in determining the risk of
developing this condition
 Almost all cases of Guillain-Barré
syndrome are sporadic, which
means they occur in people with
no history of the condition in
their family.
 Prevention and avoidance is difficult
Prevention
since not much Is known about the
cause and whether there is a genetic
component
Group Name: Dream Team
Pathophysiology/Mechanism of Pathology
 Guillain-Barre is an idiopathic disease; whose cause is
unknown.
 In this disease, the immune system targets and attacks
nerves.
 Lesions occur mainly in the PNS nerve roots of sensory and
motor fibers.
 In the most common form, AIDP, muscle weakness and
tingling begin in the lower part of the body and spreads
upward. Although, in 10% of people with this disorder
weakness and tingling start in the arms and face.
 In AIDP, the myelin sheath is damaged. This prevents the
nerves from transmitting signals. Resulting in the
numbness, weakness or paralysis.
 Usually appears after a recent respiratory or digestive tract
infection.
 Possible triggers to Guillan-Barre include: infection with
campylobacter (type of bacteria in uncooked poultry),
influenza virus, Epstein-barr virus, HIV, mycoplasma
pneumonia, surgery, Hodgkin's lymphoma, and rarely
influenza vaccinations or childhood vaccinations.
 Most significant weakness occurs 2-4 weeks after symptoms
appear.
 Recovery occurs 6-12 months after contraction, but
recovery may take up to 3 years.
 Diagnostic procedures may include: spinal tap,
electromyography, and nerve conduction studies.
Signs and Symptoms
& Medical Treatment
 First symptoms of Guillain- Barre
include weakness or tingling
sensations. Usually starting in
the legs, and can spread to the
upper body and arms.
 Unsteady walking or inability to
walk or climb stairs.
 Severe pain that may feel achy
or cramp-like and may be worse
at night.
 Rapid heart rate.
 Low or high blood pressure.
 Difficulty breathing.
 Difficulty with eye or facial
movements, including speaking,
chewing or swallowing.
Diagnostic Criteria, Prognosis Considerations & Implications for
Physical Therapists
 Difficult to diagnose in early stages
 Spinal taps to remove fluid from the
lumbar spinal canal and is then
tested for the syndrome
 Electromyography is used to
measure nerve activity within the
muscles
 Nerve conduction velocity is
observed through electrodes taped
to the skin
 No cure exists, however most
patients usually recover well
 20% of patients remain severely
disabled and 5% die
 Symptoms peak after 4 weeks and
recovery usually begins and lasts 6-
12 months but can last for up to 3
years
 Treatments that can speed up
recovery time include
plasmapheresis and Immunoglobin
therapy
 Patients also receive medication to
relieve pain and to prevent blood
clots that result from immobilization
 Weakness following the acute stages
of the syndrome can be improved
with Physical Therapy
 Physical therapy in early stages of this
condition is to maintain range of motion and
monitor muscle strength.
 Therapy should center on preventing
complications that come from
immobilization.
 Close attention to skin breakdowns and
contractures, making sure to check with
position changes in areas with bony
prominences.
 Positioning and appropriate splinting can
help alleviate patient's muscle or joint pain.
 Hot packs and gentle massage may also help
relieve their musculoskeletal pain.
 If working with them in the ICU, monitor
breathing closely.
 As the condition become more stable aquatic
therapy is a good way to initiate movement.
 It is imperative during early treatment to
gentle stretching and exercises consistent
with person's strength, not over. Over stretch
can prolong recovery.
 As the paralysis recedes neuromuscular
facilitation can be added to active/resisted
exercises.
 At this stage research has shown higher
intensity leads to more functional
improvement and reduction of disability.
Clinical Pearls
 Look for weakness or tingling that starts in the legs and then
spreading to the upper extremities. Feelings of “Pins and
Needles”.
 Symptoms may peak after four weeks and recovery usually
begins and can last six to twelve months, and possibly up to
three years.
References:
Gisbert R, Fuller KS. Chapter 39. The peripheral nervous system. In: Goodman CC, Fuller KS, eds. Pathology: Implications for the Physical
Therapist. 4th ed. St. Louis, MO: Elsevier; 2015:1687-1690.

Guillain-Barre Syndrome. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793.

Updated October 17th, 2017. Accessed October 17th, 2017.

Guillian Barre Syndrome. World Health Organization. http://www.who.int/mediacentre/factsheets/guillain-barre-syndrome/en/. Published October

2016. Accessed October 13th, 2017.

Guillain-Barre Syndrome. U.S National Library of Medicine. https://ghr.nlm.nih.gov/condition/guillain-barre-syndrome#definition. Published

October 17th, 2017. Accessed October 19th, 2017.

Yuki N, Peter-Hartung H. Guillain Barre Syndrome. The New England Journal of Medicine. June 2012. doi:10.1056/NEJMra1114525.

Review Test Questions:

1. What are the signs and symptoms of Guillain-Barre Syndrome?

a. Weakness or tingling sensations. Ex: “Pins and Needles”
b. Can witness blood in the urine.
c. Unsteady walking or inability to climb stairs.
d. A & C only
2. True or False: Guillain-Barre Syndrome often occurs after a recent respiratory or digestive tract infection.

Answers: 1.D, 2.True