Post by Master Kim on Jan 14, 2015 18:14:47 GMT -5
Guillain–Barré syndrome - en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome
Guillain–Barré syndrome (GBS) (French pronunciation: [ɡiˈlɛ̃ baˈʁe], English pronunciation: /ɡiːˈjænbɑrˈeɪ/), sometimes Guillain–Barré–Strohl syndrome or Landry's paralysis, is a medical condition in which there is a rapid-onset weakness of the limbs as a result of an acute polyneuropathy, a disorder affecting the peripheral nervous system. The disease is usually triggered by an infection, which provokes immune-mediated nerve dysfunction. Many experience changes in sensation or develop pain, followed by muscle weakness beginning in the feet and hands that develops rapidly (between half a day and two weeks). During the acute phase, the disorder can be life-threatening with about a quarter requiring admission to intensive care unit for mechanical ventilation. Some are affected by fluctuations in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.
The diagnosis is usually made on clinical grounds, through the exclusion of alternative causes, and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid. Various classifications exist, depending on the areas of weakness, results of nerve conduction studies, and presence of antiganglioside antibodies. In those with severe weakness, prompt treatment with intravenous immunoglobulins or plasmapheresis, together with supportive care, will lead to good recovery in the majority, although some may experience ongoing difficulty with walking, painful symptoms, and sometimes require breathing support. Guillain–Barré syndrome is rare, at one to two cases per 100,000 people annually. The syndrome is named after the French physicians Georges Guillain and Jean Alexandre Barré, who described it with André Strohl in 1916.
Signs and symptoms
The first symptoms of Guillain-Barré syndrome are numbness and tingling, weakness, and pain, alone or in combination. This is followed by weakness of the legs and arms that is symmetrical and worsening in time. The weakness can take half a day to over two weeks to reach maximum severity, and then becomes steady. In one in five people the weakness continues to progress for as long as four weeks. The muscles of the neck may also be affected, and about half experience involvement of the cranial nerves, which supply the head and face; this may lead to weakness of the muscles of the face, swallowing difficulties and sometimes weakness of the eye muscles. In 8% the weakness affects only the legs (paraplegia or paraparesis). Involvement of the muscles that control the bladder and anus is unusual. In total, about a third of people with Guillain-Barré syndrome continue to be able to walk. Once the weakness has stopped progressing, it persists at a stable level ("plateau phase") before improvement can be noticed. The plateau phase can take between two days and six months, but the median duration is a week.[2] Pain-related symptoms affect more than half, and include back pain, painful tingling, muscle pain and pain in the head and neck relating to irritation of the brain's lining.
Many people with Guillain-Barré have experienced the signs and symptoms of an infection in the 3-6 weeks prior to the onset of the neurological symptoms. This may consist of upper respiratory tract infection (rhinitis, sore throat) or diarrhea.
In children, particularly those younger than six years old, the diagnosis can be difficult and the condition is often initially mistaken (sometimes for up to two weeks) for other causes of pains and difficulty walking, such as viral infections, or bone and joint problems.
On neurological examination, characteristic features are the reduced power and reduced or absent tendon reflexes (hypo- or areflexia, respectively). However, a small proportion has normal reflexes in affected limbs before delevoping areflexia, and some may even have exaggerated reflexes. In the "Miller Fisher variant" subtype of Guillain-Barré syndrome (see below), weakness of the eye muscles (ophthalmoplegia) is more pronounced and may occur together with abnormalities in coordination (ataxia). The level of consciousness is normally unaffected in Guillain-Barré syndrome, but the "Bickerstaff brainstem encephalitis" subtype may feature drowsiness, sleepiness (hypersomnolence) or coma.
Respiratory failure
25% of people with Guillain-Barré syndrome develop weakness of the breathing muscles leading to respiratory failure, the inability to breathe adequately to maintain healthy levels of oxygen and/or carbon dioxide in the blood. This may require intubation of the windpipe and breathing support through mechanical ventilation, generally on an intensive care unit. The need for ventilatory support can be anticipated by measurement of two spirometry-based breathing tests: the forced vital capacity (FVC) and the negative inspiratory force (NIF). An FVC of less than 15 ml per kilogram body weight or an NIF of less than 60 cmH2O are considered markers of severe respiratory failure. This life-threatening scenario is complicated by other medical problems such as pneumonia, severe infections, blood clots in the lungs and bleeding in the digestive tract in 60% of those who require artificial ventilation.
Autonomic dysfunction
The autonomic or involuntary nervous system, which is involved in the control of body functions such as heart rate and blood pressure, is affected in two thirds of people with Guillain-Barré syndrome, but the impact is variable. Twenty percent may experience severe blood pressure fluctuations and irregularities in the heart beat, sometimes to the point that the heart beat stops and requiring pacemaker-based treatment. Other associated problems are abnormalities in perspiration and changes in the pupillary response. Autonomic nervous system involvement can affect even those who do not have severe muscle weakness.
Guillain–Barré syndrome (GBS) (French pronunciation: [ɡiˈlɛ̃ baˈʁe], English pronunciation: /ɡiːˈjænbɑrˈeɪ/), sometimes Guillain–Barré–Strohl syndrome or Landry's paralysis, is a medical condition in which there is a rapid-onset weakness of the limbs as a result of an acute polyneuropathy, a disorder affecting the peripheral nervous system. The disease is usually triggered by an infection, which provokes immune-mediated nerve dysfunction. Many experience changes in sensation or develop pain, followed by muscle weakness beginning in the feet and hands that develops rapidly (between half a day and two weeks). During the acute phase, the disorder can be life-threatening with about a quarter requiring admission to intensive care unit for mechanical ventilation. Some are affected by fluctuations in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.
The diagnosis is usually made on clinical grounds, through the exclusion of alternative causes, and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid. Various classifications exist, depending on the areas of weakness, results of nerve conduction studies, and presence of antiganglioside antibodies. In those with severe weakness, prompt treatment with intravenous immunoglobulins or plasmapheresis, together with supportive care, will lead to good recovery in the majority, although some may experience ongoing difficulty with walking, painful symptoms, and sometimes require breathing support. Guillain–Barré syndrome is rare, at one to two cases per 100,000 people annually. The syndrome is named after the French physicians Georges Guillain and Jean Alexandre Barré, who described it with André Strohl in 1916.
Signs and symptoms
The first symptoms of Guillain-Barré syndrome are numbness and tingling, weakness, and pain, alone or in combination. This is followed by weakness of the legs and arms that is symmetrical and worsening in time. The weakness can take half a day to over two weeks to reach maximum severity, and then becomes steady. In one in five people the weakness continues to progress for as long as four weeks. The muscles of the neck may also be affected, and about half experience involvement of the cranial nerves, which supply the head and face; this may lead to weakness of the muscles of the face, swallowing difficulties and sometimes weakness of the eye muscles. In 8% the weakness affects only the legs (paraplegia or paraparesis). Involvement of the muscles that control the bladder and anus is unusual. In total, about a third of people with Guillain-Barré syndrome continue to be able to walk. Once the weakness has stopped progressing, it persists at a stable level ("plateau phase") before improvement can be noticed. The plateau phase can take between two days and six months, but the median duration is a week.[2] Pain-related symptoms affect more than half, and include back pain, painful tingling, muscle pain and pain in the head and neck relating to irritation of the brain's lining.
Many people with Guillain-Barré have experienced the signs and symptoms of an infection in the 3-6 weeks prior to the onset of the neurological symptoms. This may consist of upper respiratory tract infection (rhinitis, sore throat) or diarrhea.
In children, particularly those younger than six years old, the diagnosis can be difficult and the condition is often initially mistaken (sometimes for up to two weeks) for other causes of pains and difficulty walking, such as viral infections, or bone and joint problems.
On neurological examination, characteristic features are the reduced power and reduced or absent tendon reflexes (hypo- or areflexia, respectively). However, a small proportion has normal reflexes in affected limbs before delevoping areflexia, and some may even have exaggerated reflexes. In the "Miller Fisher variant" subtype of Guillain-Barré syndrome (see below), weakness of the eye muscles (ophthalmoplegia) is more pronounced and may occur together with abnormalities in coordination (ataxia). The level of consciousness is normally unaffected in Guillain-Barré syndrome, but the "Bickerstaff brainstem encephalitis" subtype may feature drowsiness, sleepiness (hypersomnolence) or coma.
Respiratory failure
25% of people with Guillain-Barré syndrome develop weakness of the breathing muscles leading to respiratory failure, the inability to breathe adequately to maintain healthy levels of oxygen and/or carbon dioxide in the blood. This may require intubation of the windpipe and breathing support through mechanical ventilation, generally on an intensive care unit. The need for ventilatory support can be anticipated by measurement of two spirometry-based breathing tests: the forced vital capacity (FVC) and the negative inspiratory force (NIF). An FVC of less than 15 ml per kilogram body weight or an NIF of less than 60 cmH2O are considered markers of severe respiratory failure. This life-threatening scenario is complicated by other medical problems such as pneumonia, severe infections, blood clots in the lungs and bleeding in the digestive tract in 60% of those who require artificial ventilation.
Autonomic dysfunction
The autonomic or involuntary nervous system, which is involved in the control of body functions such as heart rate and blood pressure, is affected in two thirds of people with Guillain-Barré syndrome, but the impact is variable. Twenty percent may experience severe blood pressure fluctuations and irregularities in the heart beat, sometimes to the point that the heart beat stops and requiring pacemaker-based treatment. Other associated problems are abnormalities in perspiration and changes in the pupillary response. Autonomic nervous system involvement can affect even those who do not have severe muscle weakness.
Based on Ascetic Saahm's formula #1, fostering large intestine,
subdue LU10, ST41, SP2, BL60, KI2, GB38 and LR2.