What neurological manifestations indicate Guillain-Barré syndrome?

Guillain Syndrome – Barre is a disease that is accompanied by an acute inflammatory process of autoimmune etiology, and is characterized by demyelinating polyradiculoneuropathy. The main characteristic sign of the – the presence of peripheral paralysis along with protein-cell dissociation in the cerebrospinal fluid. Guillain-Barré syndrome is established at any age in the presence of increasing areflexia and weakness in more than one limb. To make a diagnosis, it is necessary to exclude other pathological conditions that have a similar clinical picture.

Clinical manifestations of Guillain-Barré syndrome

Clinical symptoms of Guillain's syndrome – Barre starts with muscle weakness and sensory disturbances. The symptoms are first present in the lower extremities, then after some time spread to the upper extremities. Often, the pathology is manifested by pain in the muscles of the arms and legs, as well as in the lumbar region.

Sometimes manifestations may begin with a cranial lesion – cerebral nerves. In this case, the degree of muscle weakness can vary from mild lesions to significant tetraplegia. With Hyena syndrome – Barre noted a decrease in tendon reflexes. Paresis is symmetrical and more pronounced in the lower extremities.

Muscle weakness may contribute to respiratory failure.

Sensitivity is disturbed by a polyneurotic type. In most patients, there are violations of deep sensitivity, which sometimes comes to its loss. Pathological changes in the cranial nerves are manifested by bulbar disorders and paresis of facial muscles.

Vegetative disorders in Guillain's syndrome – Barre manifest:

• arterial hypertension;
• arrhythmia;
• gastrointestinal dysfunction;
• impaired function of the pelvic organs;
• excessive sweating;
• reddening of the skin.

Criteria for the diagnosis of Guillain's syndrome – Barre. Differential diagnosis of

syndrome

If Guillain's syndrome is suspected – Barre and diagnosis, it is important to clarify the predisposing factors. These include recent vaccinations, past infections, tumors, and surgery. In addition to a neurological examination, it is important to conduct general clinical studies, in particular, to examine the cerebrospinal fluid.

The diagnosis is confirmed by the presence of progressive muscle weakness in more than one limb, in the absence of tendon reflexes in them. Pelvic abnormalities, paresis asymmetry, and the presence of polymorphonuclear leukocytes should call into question the correct diagnosis of Guillain's syndrome – Barre.

It is important to differentiate the diagnosis from poliomyelitis, various polyneuropathies, myasthenia gravis and stroke.

Polyneuropathy in acute intermittent porphyria may have many features similar to Guillain's syndrome – Barre. However, with porphyria, psychopathological symptoms are present in the form of hallucinations. It is also necessary to conduct a differential diagnosis with extensive ischemic stroke, which is accompanied by tetraparesis. Myasthenia gravis is characterized by variability in symptoms and the absence of sensory disturbances.

What is the treatment of Guillain's syndrome – Barre?

Patients diagnosed with Guillain's syndrome – Barre are subject to mandatory hospitalization in the intensive care unit and intensive care. In the third part of cases, there is a need for mechanical ventilation due to the development of respiratory failure. When disconnected from the apparatus, they are gradually transferred to forced ventilation of the lungs. Of great importance is the change in the position of the patient's body.

Specific therapy for Guillain's syndrome – Barre consists in the use of plasmapheresis and pulse – therapy, which is carried out with class G immunoglobulins. These procedures are aimed at stopping the autoimmune process.