GUILLAIN-BARRE SYNDROME

Acute, frequently severe and fulminant, poly radiculopathy,which is auto immune in nature.Males and females equally affected. More frequent in adults than in children.Variants involving the cranial nerves, pure motor involvement etc are also found. In severe cases, muscle weakness may lead to respiratory failure,with auto nomic involvement and unstable hemodynamics, necessitating ventilatory management
Clinical Manifestations

• Rapidly evolving, progressive, ascending motor paralysis with or without sensory disturbance and with areflexia
• Lower cranial nerves are frequently involved and presented with difficulty in swallowing and maintaining airway
• Bulbar involvement is most frequently manifested as B/L facial paralysis
• Fever and other constitutional symptoms are usually absent
• Diminished DTR with absent proprioception. There may be marked sensory loss
• Bladder dysfunction is late and transient.
• Deep aching pain in muscles and back
• Difficulty in swallowing due to pharyngeal muscle weakness and impaired ventilation due to intercostal muscle paralysis in 30% of cases and they require ventilatory support
• Marked autonomic dysfunction leads to  Wide fluctuations in blood pressure – hypo / hyper tension, Sudden profuse diaphoresis,Peripheral vasoconstriction Resting tachycardia,Cardiac conduction abnormality, Orthostatic hypotension – severe, Thromboembolism due to immobilisation, & sudden death
• Metabolic derangements -Hyponatremia due to excessive ADH secretion