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Neurocritical care and the facts fast: Part 2

(BQ) Continued part 1, part 2 of the document Neurocritical care and the facts fast has contents: Myasthenia gravis, isolated seizures, status epilepticus, determination of brain death, organ donation, guillain–barré syndrome, and other contents. Invite you to refer. | Neurocritical care and the facts fast: Part 2 IV Neuromuscular Disorders 111 10 Guillain–Barré Syndrome Guillain–Barré syndrome (GBS) is an autoimmune disorder of the peripheral nervous system. In GBS, the body’s immune sys- tem destroys the myelin sheath and the body’s ability to carry nerve signals, resulting in progressive weakness and possible autonomic dysfunction. This can create hemodynamic instabil- ity, requiring critical care interventions. In this chapter, you will learn how to: ■ Describe symptoms of GBS. ■ Diagnose GBS. ■ Review treatment strategies for GBS. EPIDEMIOLOGY ■ Rare: 1 to 2 in 100,000 per year ■ Slightly more common in men than women (1.25:1) ■ Bimodal incidence ■ Children and young adults ■ Patients over the age of 55 years ❏ Higher rates in older adults ■ Occurs more commonly during winter months 113 113 114 PATHOPHYSIOLOGY The exact pathophysiology of GBS is poorly understood; however, it PART  IV  NEUROMUSCULAR DISORDERS is typically agreed upon that the immune system is activated by some type of precipitating event/factor that leads to autoantibody produc- tion. Often, it appears that viral or bacterial infection occurs prior to GBS. One theory regarding the disease process is that the infection itself changes nervous system cells in a way that essentially makes them unrecognizable to the immune system, which subsequently treats them as foreign cells. Another theory is that the infection makes the immune system hyperactive and attacks the myelin. In GBS, the peripheral nervous system is affected, mostly the spi- nal and cranial nerve roots; however, autonomic nerves can also be affected. Once the myelin sheath, which surrounds axons, or even axons themselves are destroyed by the immune system, the nerves cannot transmit signals appropriately. Because the nerve pathway between the brain and sensory is damaged, the brain cannot receive signals such .