Guillain-Barre Syndrome

        Guillain-Barre Syndrome (GBS) is an autoimmune neurological disease in rare cases, in which the immune system produces antibodies against its own nerve, resulting in damage of the nerve. Guillain-Barre syndrome is also called acute inflammatory demyelinating polyneuropathy that attacks the nerve roots both ventral and dorsal acute symptoms and lead to paralysis of the lower limbs begin and extends up the body and facial muscles.

       Guillain Barre syndrome is acute on the human body's immune system attacks the peripheral nervous system and central nervous system rarely attacked. Peripheral nervous system, delivering sensory information (eg, pain, temperature) from the body to the brain, and delivering motor signals (eg motion) from the brain to the body. General weakness and paralysis of the legs and arms are characteristic of Guillain Barre Syndrome. Loss of sensation and paralysis may occur in the limbs, fingers, upper body and face.

       In 1859, Landry published a report on 10 patients with ascending paralysis. Subsequently, in 1916, three French doctor (Guillain, Barre and Strohl) found 2 French soldiers with the motor weakness, areflexia, dissociation albuminocytological LCS, and decreased deep tendon reflexes. This syndrome was later identified as Guillain-Barre syndrome (GBS). Historically, SGB is a single disease, but in practice this time can be found several variants. The annual incidence rate is 1-2 per 100 000 cases. This syndrome can occur at any age, but is most common between the ages of 30 and 50. GBS is a heterogeneous disease in which about two-thirds of the patients reported no previous illness, usually an infection, such as diarrhea or upper respiratory tract infection. GBS is usually a process of immune-mediated dysfunction characterized by motor, sensory and autonomic.

       Although this syndrome is a disease largely healed perfectly functional, but not uncommon death due to acute illness journey and extends to the upper body, causing respiratory failure. For that close supervision and good handling in patients with GBS is necessary to decrease the mortality rate and reduce neurological deficits sequelae.

       Some of the  names called  by some scientists, for this disease, namely idiopathic polyneuritis, polyneuritis Acute Febrile, infective polyneuritis, Post Infectious polyneuritis, Acute inflammatory demyelinating Polyradiculoneuropathy, Guillain Barre Syndrome Strohl, Landry Ascending paralysis and Landry Guillain Barre Syndrome.

Here are the classification of the SGB, namely:

1. Acute motor-sensory axonal Neuropathy (AMSAN)
Often arise quickly and suffered severe paralysis with improvements slow and bad. Such type of SAFE-related infections C. jejuni gastrointestinal tract. Pathology found is degeneration of axons sensory and motor nerve fibers are a little bit heavy with demyelination.
2. Acute Motor-axonal Neuropathy (AMAN)
Associated with C. jejuni gastrointestinal infections and antibody titer gangliosid increased (eg, GM1, GD1a, GD1b). People with this type have motor clinical symptoms and clinically typical for the type of demyelination with asending and symmetrical paralysis. SAFE distinguished by the results of the study Electrodiagnostic which found the aksonopati motor. In the biopsy showed degeneration 'wallerian like' no lymphocytic inflammation. Repairs fast, disability suffered by the patient for about 1 year.
3. Miller Fisher Syndrome
Variations of the SGB are common and constitute 5% of all cases of GBS. This syndrome consists of ataxia, and areflexia opmtalmoplegia. ataxia seen the gait and the trunk and extremities rarely covers. Motor is usually not affected. Improvements occurred in a matter of perfect weeks or months
4. Chronic Inflammatory Demyelinative polyneuropathy (CIDP)
CIDP has a clinical picture like AIDP, but the development of neurologinya symptoms are chronic. In some children, more motor abnormalities dominant and more severe muscle weakness in the distal
5. acute pandysautonomia
Without sensory and motor GBS is a rare type. Dysfunction of the sympathetic system and cause severe parasimpatis postural hypotension, urinary retention and gastrointestinal tract, anhidrosis, decrease salvias and lacrimation and abnormalities of the pupil.

This disease occurs worldwide, its incidence in all seasons. Dowling et gain frequency season common in late summer and autumn where there is an increase in cases of influenza. In this research, Zhao Baoxun found  that this disease occurs in almost every moment of every month in a year, yet it seems that 60% of cases occur between the months of July s / d in October is in late summer and autumn.

        Mortality Occurs mostly due to severe autonomic instability or long intubation Complications and Deaths in the USA paralysis. Figure range 5-10% of cases. Incidence rate in men than women are 1,5:1.3
        Incidence of Guillain-Barre syndrome varies between 0.6 to 1.9 cases per 100,000 people per year. Over a period of 42 years Central Medical Mayo Clinic do some research to get the incidence rate of 1.7 per 100,000 people. Peak incidence occurs between the ages of 15-35 years and between 50-74 years old.
Rarely under the age of 2 years. Youngest age reported is 3 months old and the oldest was 95. Men and women are equal. Of racial groupings found that 83% of patients were white, 7% black, 5% Hispanic, 1% Asian and 4% in non-specific race group. Highest incidence in Indonesia is the decade I, II, III (under age 35 years) with the number of men and women almost equally. While research in London said that the ratio of men and women 3 to 1 with an average age of 23.5 years. Incidence was highest in April s / d May in which a change of wet and dry seasons.


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•    Etiology of Guillain–Barré Syndrome•    Pathophysiology of Guillain-Barré Syndrome•    Clinical Manifestations of Guillain-Barré Syndrome•    Medical Treatment and Therapy of Guillain–Barré syndrome•    How to Diagnose Guillain–Barré syndrome
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