41. Guillain-Barré Syndrome
Definition
Guillain-Barré syndrome is an acute, ascending motor neuron paralysis that progresses very rapidly. This disease is also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute idiopathic polyneuritis, or acute inflammatory polyneuropathy.
Incidence
The incidence of Guillain-Barré syndrome ranges from 0.5:100,000 to 1.5:100,000. It is reported in all races. This disease has a slightly higher occurrence in males than in females (1.2:1). Risk of the disease increases steadily after age 40 years and peaks at 70 to 80 years.
Etiology
Guillain-Barré syndrome is an autoimmune-mediated malady frequently triggered by environmental factors, which can be pathogenic or stressful exposures. Pathogenic triggers usually precede the onset of symptoms by 1 to 3 weeks. The triggers include Epstein-Barr virus, cytomegalovirus, hepatitis, varicella, Mycoplasma pneumoniae, and Campylobacter jejuni. Endogenous antigens include myelin P-2, ganglioside GQ1b, GM1, and GT1a.
Signs and Symptoms
• Ataxia
• Autonomic instability
• Dysesthesias
• Illness or immunization 2 to 4 weeks before onset of symptoms
• Ophthalmoplegia
• Orthostatic hypotension
• Pain
• Polyneuritis cranialis
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