NURSING CARE RELATED TO THE SENSORY AND
NEUROLOGICAL SYSTEMS
2-32
2-32. GUILLAIN-BARRE SYNDROME
a. Definition. Guillain-Barre Syndrome is a disorder of the nervous system that affects peripheral nerves and spinal nerve roots. It is also called infectious polyneuritis.
b. Cause. The exact cause of Guillain-Barre syndrome is unknown. Many patients give a history of a recent infection, especially of the upper respiratory tract. There is also evidence of a connection with the Swine flu vaccination. Diagnosis is made on the basis of the history and symptoms. Additionally, lumbar puncture will reveal increased protein in the CSF.
c. Signs and Symptoms.
(1) Motor weakness, especially in the extremities, is often the first symptom.
(2) Weakness usually progresses (ascends), over a period of several hours to one week, to the upper areas of the body, where muscles of respiration may be affected.
(3) Sensory disturbances, numbness, and tingling.
(4) Cranial nerve involvement resulting in difficulty chewing, talking, and swallowing.
(5) Diminished or absent deep tendon reflexes.
(6) Low grade fever.
d. Nursing Management.
(1) Treatment is nonspecific and symptomatic.
(2) Patient must be continuously observed for adequacy of respiratory effort.
(3) Continuous EKG monitoring.
(4) Supportive nursing care measures indicated by the patient's degree of paralysis.
(5) In several weeks, paralysis will begin to disappear, usually starting from the head and moving downward.
(6) Residual effects are rare, but prolonged flaccid paralysis may lead to muscle atrophy requiring rehabilitation and physical therapy.
