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Guillain Barre syndrome

M.W. Everett | 15.07.2006 07:02 | Mayday 2006 | Analysis | World

Guillain Barre syndrome mimicking cerebral death: In the matter of the Arlene Berry Case - for the attention of Ontario's Chief Coroner. Pay attention asshole...

Guillain-Barré syndrome (GBS) is a group of autoimmune syndromes consisting of demyelinating and acute axonal degenerating forms of the disease. Nerve conduction study helps differentiate the heterogeneous subtypes of GBS. Patients exhibit a progressive paralysis that reaches a plateau phase. In most patients, resolution is complete or near complete. Mortality from GBS most often is associated with dysautonomia and mechanical ventilation. GBS usually is associated with an antecedent infection by one of several known pathogens. Cross-reactivity between the pathogen and the nerve tissue sets up the autoimmune response. Acute infectious illnesses are well-known antecedent events in two thirds of patients who have GBS. Cross-reactivity between the pathogen and the nerve tissue sets up the autoimmune response.

All patients who have GBS should be admitted to a hospital for close observation for respiratory compromise, cranial nerve dysfunction, and autonomic instability. Autonomic nervous system dysfunction may manifest as fluctuations in blood pressure, cardiac dysrhythmias, gastrointestinal pseudo-obstruction, and urinary retention.1 Prophylaxis for deep venous thrombosis should be provided because patients frequently are immobilized for many weeks.

A feature common in all GBS variants is a rapidly evolving polyradiculoneuropathy preceded by a triggering event, most often an infection.1 GBS generally manifests as a symmetric motor paralysis with or without sensory and autonomic disturbances

Misdiagnosis of brain death in the patient with severe Guillain-Barré syndrome who develops fixed dilated pupils is no bar to criminal negligence. (a) March/Case2.pdf#search='GuillainBarre Syndrome, dilated pupils'

M.W. Everett
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