Medical Treatment and Therapy of Guillain–Barré syndrome

In most patients, it can heal itself. Generally, treatment is symptomatic. Although it is said that it can heal itself, should be considered a long treatment time and number of disability or (sequelae) is high enough to keep the treatment should be given. The goal of therapy is to reduce the severity of disease specific and accelerate healing through the immune system (immunotherapy).

1) Corticosteroids

Most studies suggest that the use of steroid preparations have no value / no benefit for the treatment of GBS.

2) Plasmapheresis

Plasmapheresis or plasma exchange aims to remove circulating autoantibodies factor. Use Plasmapheresis on GBS showed good results, such as more rapid clinical improvement, use breathing aids fewer and shorter treatment duration. Treatment is done by replacing the 200-250 ml plasma / kg in 7-14 hari. Plasmapheresis more beneficial when given during the early onset of symptoms (first week).

3) Treatment of immunosuppressants:

• IV immunoglobulin (IVIg)

Treatment with gamma globulin intervena more profitable than plasmaparesis because side effects / complications lighter. Intravenous inffusion of human immunoglobulin (IVIg) can neutralize the pathological autoantibodies exist or suppress the production of auto antibodies. IVIg can also accelerate the catabolism of IgG, which then neutralize antigens from viruses or bacteria that T cells are not formed pathological. Giving IVIg was performed within 2 weeks after symptoms appeared with a dose of 0.4 g / kg bw / day for 5 days. Giving PE combined with IVIg did not give better results as compared to just give PE or IVIg. There is some literature that says that the maintenance dose of 0.4 g / kg / day for 3 days followed by a maintenance dose of 0.4 g / kg / day every 15 days to recover.

• Cytotoxic drugs

Provision of cytotoxic drugs is recommended:

a) 6 merkaptopurin (6-MP)

b) azathioprine

c) cyclophosphamid

Side effects of these medications are: alopecia, vomiting, nausea and headache

4. Fisiotherapy also be done to improve the strength and flexibility of muscles after paralysis.

5. Low-dose heparin may be given to prevent thrombosis.

6. The instability of blood pressure may also occur. Antihypertensive drugs and vasoactive drugs must also be prepared.


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