Guillain-Barré Syndrome

  • gullain-barre syndrome Also known as polyradiculoneuritis.
  • It is an acute inflammatory polyneuropathy of the peripheral sensory and motor and nerve roots.
  • Affected nerves are demyelinated with possible axonal degeneration.
  • It’s exact cause is unknown, Guillain-Barré Syndrome is believed to be an autoimmune disorder that may be triggered by viral infection, Campylobacter diarrheal illness, immunization, or other precipitating event.
  • The syndrome is marked by acute onset of symmetric progressive muscle weakness, most often beginning in the legs and ascending to involve the trunk, upper extremities, and facial muscles. Paralysis may develop.
  • Complications may include respiratory failure, cardiac arrhythmias, and complications of immobility.


  1. Acute onset (hours to weeks) of progressive, usually ascending muscle weakness and fasciculation, possibly leading to paralysis (maximal weakness is reached within 2 weeks).
  2. Paresthesia and painful sensations.
  3. Possible hypoventilation due to chest muscle weakness.
  4. Difficulty with swallowing, chewing, speech, and gag, indicating fifth (trigeminal) and ninth (glossopharyngeal) cranial nerve movement.
  5. Reduce or absent deep tendon reflexes, position and vibratory perception.
  6. Autonomic dysfunction with orthostatic hypotension and tachycardia.

Diagnostic Evaluation:

  1. Lumbar puncture obtains cerebrospinal fluid samples, which reveal low cell count and high protein levels.
  2. Nerve conduction studies, which allow decreased conduction velocity of peripheral nerves due to demyelination.
  3. Abnormal laboratory studies may point to prior infection or illness.

Pharmacologic Interventions:

  1. Analgesics and muscle relaxants to control painful sensations and fasciculations.

Nursing Interventions:

  1. Monitor respiratory status through vital capacity measurements, rate and depth of respirations, and breath sounds.
  2. Monitor level of muscle weakness as it ascends toward respiratory muscles. Watch for breathlessness while talking which is a sign of respiratory fatigue.
  3. Monitor the patient for signs of impending respiratory failure.
  4. Monitor gag reflex and swallowing ability.
  5. Position patient with the head of bed elevated to provide for maximum chest excursion.
  6. Avoid giving opioids and sedatives that may depress respirations.
  7. Position patient correctly and provide range-of-motion exercises.
  8. Provide good body alignment, range-of-motion exercises, and change of position to prevent complications such as contractures, pressure sores, and dependent edema.
  9. Ensure adequate nutrition without the risk of aspiration.
  10. Encourage physical and occupational therapy exercises to help the patient regain strength during rehabilitation phase.
  11. Provide assistive devices  as needed (cane or wheelchair) to maximize independence and activity.
  12. If verbal communication is possible, discuss the patient’s fears and concerns.
  13. Provide choices in care to give the patient a sense of control.
  14. Teach patient about breathing exercises or use of an incentive spirometer to reestablish normal breathing patterns.
  15. Instruct patient to wear good supportive and protective shoes while out of bed to prevent injuries due to weakness and paresthesia.
  16. Instruct patient to check feet routinely for injuries because trauma may go unnoticed due to sensory changes.
  17. Urge the patient to maintain normal weight because additional weight will further stress monitor function.
  18. Encourage scheduled rest periods to avoid fatigue.

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