Cranial nerve commonly involved in Guillain Barre syndrome is: March 2009

Ans. D: Facial Signs and symptoms may take days or weeks to develop and days, months, or even years to fully disappear. The severity of patient's condition depends on the extent of nervous system involvement-that is, the extent of demyelination. Cranial nerve involvement is present in 85% of cases, with the facial nerve (cranial nerve VII) most often affected. The glossopharyngeal (cranial nerve IX), vagus (cranial nerve X), spinal accessory (cranial nerve XI), and hypoglossal (cranial nerve XII) nerves also may be affected. Signs and symptoms of facial nerve dysfunction include inability to smile, frown, whistle, or use a straw when drinking. Paralysis of cranial nerves IX and X can cause dysphagia and laryngeal paralysis. Autonomic dysfunction may occur if the vagus nerve is affected. Motor weakness and paralysis usually begin in the legs, progressing to the trunk and arms. If sensory symptoms are present, patients may complain of paresthesias and pain. After the first few days of weakness and paresthesias, physical assessment will reveal diminished (hyporeflexia) or absent deep tendon reflexes (areflexia) in the involved extremities. Areflexia is considered a key assessment finding in GBS. Respiratory failure is thought to be caused by involvement of the muscles of respiration, including the diaphragm and the intercostals. GBS doesn't affect the patient's cognitive function, level of consciousness, or pupillary signs. Autonomic dysfunction-signs and symptoms include cardiac dysrhythmias, paroxysmal hypotension, ohostatic hypotension, paralytic ileus, urinary retention, and syndrome of inappropriate secretion of antidiuretic hormone.