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Gullian Barre

neuro rehab

QuestionAnswer
causes of gbs inflammation occurs 2ndary to immune reaction; peripheral nerves are recognized as foreign
T/F GNS only has PNS involvement. true
What can happen to myelin in GBS? myelin damaged/disrupted slowing conduction
Are axons damaged in GBS? they can be
PNS involvement in GBS changes in sensory, changes in motor, ascending from feet
Is GBS worse in children or adults? adults
How is GBS diagnosed? spinal tap (increased fluid protein); NCV/EMG (abnormal conduction); rule out other diagnoses
How does weakness progress in GBS? weakness caudal to cephalal; symmetry of symptoms (stocking glove distrib)
What changes in sensation do people with GBS experience? loss of vibration, proprioception, touch, and pain distally
What is one special test that would be positive with GBS? cranial nerve tests
What are some autonomic impacts of GBS and will the pt be fatigued? decreased breathing and changes in HR; yes- fatigue
How long does it take to go from healthy to sick to healthy with GBS? 2 days-4 months; 4 months
How long after onset do 30% of people with GBS feel residual weakness/tingling? 2 years
What is the progression of improvement? proximal to distal
How long after GBS Sx onset do most pts walk? 6 months
What percentage of people with GBS require artificial ventilation? 25%
What percentage of people with GBS have residual permanent severe disability? (deficits in ambulation or require ventilator 12 mo later) 10-20%
How soon should therapy for GBS begin? within 2 weeks of onset
What therapeutic interventions can be utilized? plasmapheresis, corticosteroids, IV immunoglobin (IVIG), prevent bed sores, PROM, multi-podus boots, phlebitis prevention (TEDS, intermittent compression, blood thinner), gait training
What should PT schedule for GBS look like? 8-10 short bouts progressing to longer as tolerated (exhaustion = injury)
Which is better in later stages of GBS? Higher or lower intensity rehab? Higher intensity rehabilitation reduces disability in pts in later stages of GBS when compared with lower intensity rehabilitation.
Created by: wrenlette