PMID- 7641605
OWN - NLM
STAT- MEDLINE
DCOM- 19950920
LR  - 20181113
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 49
IP  - 6
DP  - 1995 Jun
TI  - Guillain-Barre syndrome. Clinical manifestations and directions for treatment.
PG  - 912-20
AB  - Guillain-Barre syndrome (GBS) is the commonest cause of acute neuromuscular 
      paralysis in the developed world today. Patients present most commonly with a 
      rapidly ascending paralysis together with sensory symptoms and variable autonomic 
      involvement. The diagnosis is clinical, but lumbar puncture and nerve conduction 
      studies are helpful in excluding other conditions. The improvement in prognosis 
      in recent years is largely due to advances in respiratory intensive care 
      management. Careful monitoring of cardiorespiratory function and in particular 
      regular measurements of the vital capacity will help to predict which patients 
      will require elective ventilation to prevent impending neuromuscular respiratory 
      failure. The paralysed patient is susceptible to all the complications of 
      immobility, in particular venous thromboembolism and hypostatic pneumonia, and 
      good nursing care and physiotherapy are therefore mandatory. Autonomic 
      involvement may predispose to cardiac arrhythmias and labile blood pressure. The 
      prolonged nature of the illness predisposes to psychiatric complications, 
      particularly depression, and this should be treated appropriately. Specific 
      treatment is aimed at reducing the period of maximum disability. Both plasma 
      exchange (PE) and intravenous immune globulin (IVIg) have been shown to be 
      effective in randomised controlled trials. A multicentre trial is currently under 
      way to determine whether PE or IVIg or PE followed by IVIg is the most effective 
      treatment for this condition. Steroids alone have not been shown to be of value, 
      although a trial is under way comparing the combination of IVIg and 
      methylprednisolone with IVIg alone. The prognosis of GBS is generally good, with 
      about 80% of patients making a full recovery, although about 5% die of 
      complications.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Rees, J
AU  - Rees J
AD  - Department of Neurology, UMDS-Guy's Hospital, London, England.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
SB  - IM
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Male
MH  - Paralysis/diagnosis/therapy
MH  - Polyradiculoneuropathy/*diagnosis/*therapy
MH  - Prognosis
MH  - Treatment Outcome
RF  - 41
EDAT- 1995/06/01 00:00
MHDA- 1995/06/01 00:01
CRDT- 1995/06/01 00:00
PHST- 1995/06/01 00:00 [pubmed]
PHST- 1995/06/01 00:01 [medline]
PHST- 1995/06/01 00:00 [entrez]
AID - 10.2165/00003495-199549060-00005 [doi]
PST - ppublish
SO  - Drugs. 1995 Jun;49(6):912-20. doi: 10.2165/00003495-199549060-00005.