Guillain-Barre Syndrome – causes, symptoms, diagnosis, treatment, pathology

Guillain-Barre Syndrome – causes, symptoms, diagnosis, treatment, pathology

learning medicine is hard work Osmosis makes it easy it takes your lectures and notes to
create a personalized study plan with exclusive videos practice questions and flashcards and so much more try it free today Guillain-Barré syndrome is named
after two neurologists Georges Guillain and Jean Barré and it’s a demyelinating disease
of the peripheral nervous system which includes all of the neurons that extend beyond
the brain and the spinal cord Guillain-Barré or GBS for short is also called acute
inflammatory demyelinating polyneuropathy neurons are made of three parts the dendrites which are the little branches that receive signals from other neurons the soma or cell body which has all of the neurons main organelles and the axon which transmits the signal to the next neuron in the series for peripheral nerves the cell body can either be located in the spinal cord where it’s called a spinal nerve or the brain where
it’s called a cranial nerve myelin is the
protective sheath that surrounds the axons of the peripheral neurons allowing them to
quickly send electrical impulses this myelin is produced by Schwann cells which are a group of
cells that support neurons in Guillain-Barré syndrome demyelination happens when the immune system inappropriately
attacks and destroys the myelin which makes communication
between neurons breakdown ultimately leading to all sorts of sensory motor and cognitive problems the cause of
Guillain-Barré syndrome is unknown but it’s known to develop
after a bacterial infection like Campylobacter Jejuni
and Mycoplasma Pneumoniae or a viral infection like Cytomegalovirus and Epstein-Barr virus to be clear these bacteria and viruses don’t directly damage the myelin sheath instead it’s thought that they have
antigens on their surface that looks similar to the lipid
in the myelin sheath as a result immune cells mistakenly attack and
destroy the myelin sheath and this is called molecular mimicry because from the perspective
of the immune cells a host substance is
mimicking a foreign protein when a normal component of the cells triggers an immune response that component is called an auto antigen so in Guillain-Barré syndrome myelin autoantigens get picked up by the antigen presenting cells like dendritic cells which present
it to helper T-cells these helper T-cells produce small signaling molecules called cytokines which activate B-cells and macrophages once activated the B-cells make antibodies that mark the auto antigens and the macrophages use
those antibody markers to bind to and strip the myelin sheath off of the peripheral neurons the demyelination happens in patches along the length of the axon so it’s called segmental demyelination early on in Guillain-Barré syndrome the Schwann cells make
new myelin to cover the neurons which is called remyelination but over time the Schwann cells
just can’t keep up and there’s irreversible damage absence of myelin sheath means that the nerve impulses become
slow and sluggish symptoms of Guillain-Barré syndrome
are based on the nerves that are affected initially there’s a loss of sensation also called paresthesia and it particularly affects nerves
that convey vibration and touch sensation when motor nerves supplying
the muscles are affected there’s initially muscle weakness
and an absence of reflexes first the ankle reflexes are lost and soon after the patellar
and arm reflexes are lost as well these are considered
lower motor neuron signs the cranial nerves can also be involved and that can cause symptoms like double vision and difficulty speaking in severe cases nerve supplying
the respiratory muscles like the diaphragm can be involved and that can eventually lead to death when autonomic nerves which regulate
various organ functions are involved there can be a variety of symptoms like bowel and bladder symptoms like constipation and urinary incontinence or orthostatic hypotension which is when there’s a decrease
in blood pressure when a person stands up to help diagnose Guillain-Barré syndrome a lumbar puncture can be
done to obtain cerebrospinal fluid the cerebrospinal fluid typically
shows an albuminocutologic dissociation which means that there’s
an increase in protein or albumin levels without an increase in white blood cells in addition nerve conduction tests
and electromyographic studies can be done to assess nerve and muscle function but sometimes these tests can be
normal early on in the disease in addition pulmonary function tests
can be done to evaluate an individual’s
respiratory function treatment of Guillain-Barré syndrome
is aimed at reducing the symptoms and involves medications which
suppress the immune system like intravenous immunoglobulin in addition plasmapheresis can be
effective as well which is when the plasma is filtered to remove the Troublesome Auto antibodies typically individuals slowly recover
over several months as there’s regrowth of the myelin
on peripheral nerves finally in rare cases individuals have developed
Guillain-Barré syndrome soon after getting the flu vaccine in those situations individuals
are often advised to avoid the flu vaccine in future years alright as a quick recap Guillain-Barré syndrome is an
autoimmune demyelinating disorder where the immune cells attack
the myelin sheath produced by Schwann cells
that cover the peripheral nerves the result is a progressive loss of
nerve impulse conduction which causes loss of sensation and
muscle paralysis in the limbs and can eventually lead to
respiratory failure typically individuals slowly
recover over several months as there’s regrowth of the myelin
on peripheral nerves thanks for watching if you’re interested in a
deeper dive on this topic take a look at where we have flashcards
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47 Replies to “Guillain-Barre Syndrome – causes, symptoms, diagnosis, treatment, pathology”

  1. The first time I heard about rare side effect of flu vaccine. I'm scared to do my flu job. Thank you so much for free and educational videos.

  2. Thanks Osmosis! Gillian Barre is a really interesting one, just remember how quickly it can progress to be life threatening, always get specialties involved early!

  3. @4:30 albuminocYtologic and not albuminocUtologic… this is because we are talking about dissociation between alubmin = prteins and cytologic = cells (WBCs in this case)

  4. Again, thank you very much for a wonderful video. I believe there is another minor mistake: @5:50 it is loss of nerve conduction velocity and not complete nerve impulse conduction loss

  5. Does anyone have problems loading their flash cards or questions on the app? Mine doesn’t load at all, it stays on the loading screen.

  6. Great info, just add to it that its a rapidly ascending paralysis which can quickly kills if not treated early

  7. I have Guillain Barré syndrome because I was dancing correctly it hurts, after abs workout after singing while swinging

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