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Medicine General 9414416c

All the following are features of Guillain-Barre syndrome except:

A
Predominant motor involvement
B
Facial nerve involvement
C
Absence of pleocytosis in CSF
D
Bladder bowel involvement
High-Yield Explanation
Answer is D (Bladder bowel involvement): Bladder bowel involvement is rare in G. B. syndrome. Bladder dysfunction may occur in severe cases but is usually transient. 'If bladder dysfunction is prominent and comes early possibilities other than GBS should be considered'.- Harrison Guillain Barre syndrome (GBS) is an autoimmune disease characterized by acute demyelinating polyneuropathy. It has several distinctive features, which are so often asked. These include : Aetiology Preceding evidence of a viral infection such as that with - Herpes group : CMV / EBV Campylobacter jejuni gastroenteritis Lymphoma / Lupus Erythematosus Clinical manifestation Predominant motor involvement Sensory disturbance Autonomic * Paraplegia / Quadriplegia * Sensory disturbance may or may not be * Autonomic involvement * Proximal muscles affected more than the present : Cutaneous sensory deficits (eg. characterized by Postural distal ones loss of pain and temperature sensation) hypotension. episodes of * Ascending pattern of paralysis when present are usually mild. hypotension or hypeension * Cranial nerve involvement 9 : The * Bladder & Bowel rarely involved deg : and tachycardia. commonest involvement is bilateral Facial Bladder dysfunction may occur in severe and then Bulbar muscles. The patient has cases but is usually transient difficulty in swallowing, speech, etc. - If bladder dysfunction is a prominent * Areflexia Q .-Deep tendon reflexes usually feature and comes early, possibilities disappear within the first few days of onset. other than GBS should be considered. CSF Findings Nerve Conduction Studies - CSF shows albumino-cytological dissociation Q.i.e. Increased proteins with normal cells - CSF Pleocytosis with cells above 50/mm3 is against the diagnosis of.GBS. - API / 35 Nerve conduction studies show demyelination i.e. slow conduction velocity, distal latency, conduction block Prognosis - Recovery is usually remarkable in GBS, although all patients may not recover fully. - Approximately 85% of patients with GBS achieve a full functional recovery within several months to a year.-Harrison 15`72509

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