Guillain-Barre Syndrome

Acute inflammatory polyneuropathy

Autoallergic

1 - 3 weeks after a viral infection

Ascending weakness

20% of cases effects respiratory muscles are effected

Nerve conduction studies show a demyelinating slowing or blockage of conduction

Treatment

Intravenous globulins

Steroids

Support

Recovery may be over months

Myasthenia gravis

Weakness and fatiguability of proximal limbs, occular and bulbar muscles, ptosis

Cause unknown - IgG antibodies to acetylecholine found in blood in 90% of cases

Immune complexes deposited on acetylecholine receptor sites on post synaptic membranes

Thymic hyperplasia

Tensilon test - edrophonium an anticholinesterase increases strength for 2 - 3 minutes

Condition has a protracted course, infections may bring on exacerbations

Treatment

Oral Pyridostigmime - inhibits cholinesterase

Possible thymectomy

Possible steroids

Possible azathioprine

Monitor and manage respiratory impairment, (ventilation occasionally required), dysphagia and nasal regurgitation