High risk and low prevalence diseases: Guillain-Barré syndrome
Authors: Joshua Madden, Anthony Spadaro, Alex Koyfman, Brit Long
Published in: American Journal of Emergency Medicine, 2023 October 29
Introduction:
- Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that can lead to severe morbidity and mortality.
Discussion:
- GBS typically develops following a bacterial or viral infection.
- It is characterized by progressive, ascending muscle weakness and hyporeflexia.
- The condition can also affect cranial nerves, respiratory function, and autonomic systems.
- Diagnosis in the ED is primarily clinical but can be supported by laboratory tests, cerebrospinal fluid (CSF) analysis, and neuroimaging.
- Albumino-cytological dissociation in CSF is not always present.
- Diagnostic criteria such as the National Institute of Neurological Disorders and Stroke and the Brighton criteria can aid in diagnosis.
- Management in the ED centers on monitoring and potentially stabilizing hemodynamic and respiratory function.
- Patients may experience cardiac arrhythmias or fluctuations in blood pressure, and respiratory muscle weakness could necessitate intubation.
- Neurology should be consulted early, and treatments include plasmapheresis (PLEX) or intravenous immunoglobulin (IVIG).
Conclusions:
- Recognizing the signs and symptoms of GBS is crucial for emergency clinicians to provide timely and effective care. Understanding the disease process, potential complications, and treatment options can be lifesaving.
Madden, J., Spadaro, A., Koyfman, A. and Long, B., 2023. High risk and low prevalence diseases: Guillain-Barré syndrome. The American Journal of Emergency Medicine.