Difficult answers to questions about Guillain-Barre syndrome

Green-Barre syndrome, also known as Guillain-Barré syndrome, is one of the common diseases of the nervous system. The main clinical manifestations are acute onset, progressive aggravation of tetraplegia, double vision, dysphagia, etc. In severe cases, the respiratory muscles may be involved, resulting in respiratory distress; in cases of long duration or severe disease, there may be muscle atrophy, causing great pain to patients. Usually there is a history of upper respiratory or gastrointestinal tract infection, surgery or trauma, or a history of vaccination within 8 weeks before the onset of the disease. The disease can affect both men and women, but it is more common in young and middle-aged men. The disease can develop in all seasons, with more in summer and autumn. Etiology: 1) Bacterial infection, especially Campylobacter jejuni infection 2) Viral infection, especially cytomegalovirus and EBV 3) Surgery/trauma/vaccination, etc. Clinical manifestations: The clinical characteristics of the disease include acute progressive symmetric limb paralysis with subjective sensory impairment within 8 weeks after infectious disease, and pain in the neck, shoulder, waist and lower limbs in some patients. The specific clinical manifestations are: (1) Movement disorders: muscle paralysis of the limbs and trunk is the most important symptom of the disease. It usually starts from the lower limbs and gradually spreads to the trunk muscles, both upper limbs and cerebral nerves, and can gradually develop from one side to the other. The paralysis is generally more proximal than distal, and the muscle tone is hypotonic. If respiration, swallowing and pronunciation are involved, it can cause life-threatening respiratory weakness and swallowing difficulties. (2) Sensory impairment: generally mild, mostly starting with numbness and pins and needles sensation at the ends of the limbs. There can also be glove-like sensory loss, disappearance or hypersensitivity, as well as spontaneous pain, pressure pain to the gastrocnemius and anterior wall muscle angle obvious (3) Plant nerve dysfunction: can appear abnormal sweating, with excessive sweating, sweat odor is strong, etc.. A few patients may have difficulty in urination and constipation at the beginning; some patients may have unstable blood pressure, tachycardia or bradycardia and abnormal electrocardiogram, etc. (4) Cerebral nerve symptoms: half of the patients have cerebral nerve damage, with tongue, pharynx and vagus nerve involvement, swallowing difficulties, weakness of speech, etc. Facial palsy on one or both sides is common. The moving eye, talipes and abducens nerve are also often involved, and double vision may occur. Treatment (1) Immunomodulatory therapy: including intravenous gammaglobulin, plasma replacement and hormone therapy. (2) Nutritional nerve therapy. (3) Symptomatic supportive therapy to prevent pulmonary infection and venous thrombosis. Prognosis Timely diagnosis and proper treatment are the keys to a good prognosis.