Gullaine-

Barré
Syndrome
Gullaine-Barré Syndrome
 is a rare disorder that causes your immune
system to attack your peripheral nervous
system (PNS)
 named after the French physicians Georges

Guillain, Jean Alexandre Barré and André

Strohl
 first symptom is usually weakness or a

tingling feeling in your legs

 Most people recover (recovery can take a few

weeks to a few years)

Subtypes
 acute inflammatory demyelinating
polyradiculoneuropathy (AIDP)
 acute motor axonal neuropathy (AMAN)
 acute motor and sensory axonal neuropathy

(AMSAN)
 Miller Fisher syndrome (MFS)
 Depiction of GBS subtypes and their relationships according to type of neuropathy
within the GBS classification.
Causes
 Autoimmune disorder with a trigger that is
unkown
 Viral
 AIDS
 Herpes Simplex
 Mononucleosis
 Epstein-Barr virus
Bacterial
 Campylobacter jejuni
 Mycoplasma pneumoniae
 Haemophilus influenzae
 Locations of GBS
peripheral nerve attack
in peripheral nervous
system.
a) Dorsal root ganglia can
be the target of an
antibody response in
MFS.
b) Nodes of Ravier are a
target of immune
response in AMAN.
c) Schwann cell myelin
surface proteins can be
the target of antibody
binding in AIDP.
d) Neuromuscular junction
(not known to be
involved with GBS)
Manifestations
Signs and Symptoms
Vital Signs • tachycardia or bradycardia, hypertension or hypotension, or
hyperthermia or hypothermia.
• Low oxygen saturation

Cranial nerves • facial weakness mimicking Bell palsy

Dysreflexia • weakness are invariably hyporeflexic or areflexic in the
involved areas.
• Poor inspiratory effort or diminished breath sounds

Motor • Symmetric limb weakness typically begins as proximal lower

extremity weakness and ascends to involve the upper
extremities, trunkal muscles, and head.
• Inability to stand or walk despite reasonable strength,
especially when ophthalmoparesis or impaired proprioception
is present.
Abdominal • Paucity or absence of bowel sounds
suggests paralytic ileus.
• Suprapubic tenderness or fullness may
be suggestive of urinary retention.
Sensory numbness, paresthesias, impaired
proprioception, and pain, tingling,
fainting

Respiratory * Shortness of breath, apnea,

dyspnea

 Additional symptoms may include:

* Blurred vision
* Clumsiness and falling
* Difficulty moving face muscles
* Muscle contractions
* Palpitations (sensation of feeling
heartbeat)
Management
 Medical Management
◦ Intubation

◦ Plasmapheresis

◦ Immunoglobulins via IV

◦ Physiotherapy
Nursing Interventions
 Turn and reposition the patient, and
encourage coughing and deep
breathing.

 If respiratory failure becomes

imminent, establish an emergency
airway with an endotracheal tube.

 Give meticulous skin care to prevent

skin-breakdown and contractures.

 Perform passive range of motion

exercises within the patient’s pain
limits.
 To prevent aspiration, test the gag
reflex and elevate the head of the
bed before giving the patient
anything to eat.

 To prevent thrombophlebitis, apply

anti-embolism stockings or
compression boots and give
prophylactic anticoagulants as
ordered.

 If the patient has facial paralysis,

give eye and mouth care every 4
hours.

 Offer bed pan every 3 to 4 hours to

monitor intake and output regularly.
 To prevent or relieve
constipation, offer
prune juice and high
bulk diet.

 Administer medications
as ordered. Analgesics
may be prescribed to
relieve muscle stiffness
and spasm.

 Provide diversions for

the patient, such as
televisions, family
visits, or listening to the
radio.

 Provide emotional
support to the patient
and his family.
References:
 http://
nursingfile.com/nursing-care-plan/nursing-interventions/nu
rsing-interventions-for-guillain-barre-syndrome.html

 http://www.ami20.com/category/guillain-barre-syndrome

 http://www.mayoclinic.com/health/guillain-barre-syndrome/
DS00413/DSECTION=complications