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Harrison's Principles of Internal Medicine, 18e
| Part 17. Neurologic Disorders > Section 3. Nerve and Muscle Disorders > |
Chapter 385. Guillain-Barré Syndrome and Other Immune-Mediated Neuropathies
Sections: Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Neuropathies with Monoclonal Gammopathy, Vasculitic Neuropathy, Anti-Hu Paraneoplastic Neuropathy, Further Readings.
Topics Discussed: guillain-barre syndrome; immune-mediated neuropathies.
Excerpt:"Guillain-Barré syndrome (GBS) is an acute, frequently severe, and fulminant polyradiculoneuropathy that is autoimmune in nature. It occurs year-round at a rate of between 1 and 4 cases per 100,000 annually; in the United States, ~;5000–6000 cases occur per year. Males are at slightly higher risk for GBS than females, and in Western countries adults are more frequently affected than children.GBS manifests as a rapidly evolving areflexic motor paralysis with or without sensory disturbance. The usual pattern is an ascending paralysis that may be first noticed as rubbery legs. Weakness typically evolves over hours to a few days and is frequently accompanied by tingling dysesthesias in the extremities. The legs are usually more affected than the arms, and facial diparesis is present in 50% of affected individuals. The lower cranial nerves are also frequently involved, causing bulbar weakness with difficulty handling secretions and maintaining an airway; the diagnosis in these patients may initially be mistaken for brainstem ischemia. Pain in the neck, shoulder, back, or diffusely over the spine is also common in the early stages of GBS, occurring in ~;50% of patients. Most patients require hospitalization, and in different series up to 30% require ventilatory assistance..."
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