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