Guillain-Barré syndrome physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
Physical Examination
Physical examination of patients with Guillain Barre syndrome is usually remarkable for:
Appearance of the Patient
- Patients with Guillain Barre syndrome might have abnormal gait.[1]
Vital Signs
- Tachycardia or bradycardia
- Blood pressure disturbance[2]
Skin
- Skin examination of patients with Guillain Barre syndrome is usually normal.
- We might see evidence of recent chicken pox disease.[3]
HEENT
- Extra-ocular movements may be abnormal (ophthalmologist).[1]
- Ophthalmoscopic exam may be abnormal with findings of papilledema.[4]
- Hearing acuity may be reduced.[5]
- facial myokymia (Involuntary facial movement)[6]
- vocal cord paralysis (Difficulty speaking)[7]
Neck
- We might see some Lymphadenopathy because of prior infection with EBV or CMV.[8][3]
- Using accessory muscle for breathing in severe cases.
Lungs
- Pulmonary examination of patients with Guillain barre syndrome is usually normal.
Heart
- Cardiovascular examination of patients with Guillain Barre syndrome is usually normal.
Abdomen
- Abdominal examination of patients with Guillain Barre syndrome is usually normal.
Back
- Back examination of patients with Guillain Barre syndrome is usually normal.
Genitourinary
- Evidences of urinary retention may be present.[2]
Neuromuscular
- Patient is usually oriented to persons, place, and time.
- Altered mental status may be present.
- Glasgow coma scale is 15/ 15
- Based on the type of GBS, hyperreflexia or areflexia may be present.
- Bilateral distal and proximal muscle weakness is present.
- Reduced muscle force especially in lower extremities.
- Unilateral or bilateral sensory abnormality especially in deep sensation in the upper/lower extremities.
- Abnormal gait is present in Miller fisher type of GBS.[9][10][11][12][2]
Extremities
- Extremities examination of patients with Guillain Barre syndrome is usually normal.
References
- ↑ 1.0 1.1 Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T (April 2001). "Clinical features and prognosis of Miller Fisher syndrome". Neurology. 56 (8): 1104–6. PMID 11320188.
- ↑ 2.0 2.1 2.2 Template:Victor, M., 2001. Diseases of spinal cord peripheral nerve and muscle. Principles of Neurology
- ↑ 3.0 3.1 Winer JB, Hughes RA, Anderson MJ, Jones DM, Kangro H, Watkins RP (May 1988). "A prospective study of acute idiopathic neuropathy. II. Antecedent events". J. Neurol. Neurosurg. Psychiatry. 51 (5): 613–8. PMC 1033063. PMID 3404161.
- ↑ JOYNT RJ (January 1958). "Mechanism of production of papilledema in the Guillain-Barre syndrome". Neurology. 8 (1): 8–12. PMID 13493684.
- ↑ Nelson KR, Gilmore RL, Massey A (August 1988). "Acoustic nerve conduction abnormalities in Guillain-Barré syndrome". Neurology. 38 (8): 1263–6. PMID 3399076.
- ↑ Mateer JE, Gutmann L, McComas CF (March 1983). "Myokymia in Guillain-Barré syndrome". Neurology. 33 (3): 374–6. PMID 6681885.
- ↑ Panosian MS, Quatela VC (February 1993). "Guillain-Barré syndrome presenting as acute bilateral vocal cord paralysis". Otolaryngol Head Neck Surg. 108 (2): 171–3. doi:10.1177/019459989310800211. PMID 8441543.
- ↑ Irie S, Saito T, Nakamura K, Kanazawa N, Ogino M, Nukazawa T, Ito H, Tamai Y, Kowa H (August 1996). "Association of anti-GM2 antibodies in Guillain-Barré syndrome with acute cytomegalovirus infection". J. Neuroimmunol. 68 (1–2): 19–26. PMID 8784256.
- ↑ Cochen V, Arnulf I, Demeret S, Neulat ML, Gourlet V, Drouot X, Moutereau S, Derenne JP, Similowski T, Willer JC, Pierrot-Deseiligny C, Bolgert F (November 2005). "Vivid dreams, hallucinations, psychosis and REM sleep in Guillain-Barré syndrome". Brain. 128 (Pt 11): 2535–45. doi:10.1093/brain/awh585. PMID 16000335.
- ↑ Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.
- ↑ Kuwabara S, Nakata M, Sung JY, Mori M, Kato N, Hattori T, Koga M, Yuki N (July 2002). "Hyperreflexia in axonal Guillain-Barré syndrome subsequent to Campylobacter jejuni enteritis". J. Neurol. Sci. 199 (1–2): 89–92. PMID 12084449.
- ↑ Kuwabara S, Ogawara K, Koga M, Mori M, Hattori T, Yuki N (August 1999). "Hyperreflexia in Guillain-Barré syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody". J. Neurol. Neurosurg. Psychiatry. 67 (2): 180–4. PMC 1736477.