Clinical Case Database / Category: Patient Management

Guillain-Barré: don't wait for the saturations to drop!

Publication details

Claire Sutton, Emma Gendall, Nigel Page
Foundation Years Journal, volume 4, issue 3, p.29 (123Doc Education, London, March 2010)

Abstract

This case will discuss the care of a patient with Guillain–Barré syndrome. It will include revision of the presentation and treatment of the syndrome, and illustrate the importance of recognising the early warning signs of impending respiratory compromise as a junior doctor.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Authors

Claire Sutton

Specialist Registrar in Elderly Care Medicine
Sandwell and West Birmingham NHS Trust
claire.sutton@uhb.nhs.uk

Emma Gendall

Foundation Year 1 Doctor
Sandwell and West Birmingham NHS Trust
egendall@doctors.org.uk

Nigel Page

Consultant in Elderly Care
nigel.page@swbh.nhs.uk

References

1. Winer JB (2008) Guillain–Barré syndrome. BMJ, 337:227–228.
2. Jacob BC, Rothbarth PH, Van der Meche FGA, et al. (1998) The spectrum of antecedent infections in Guillain–Barré syndrome. A case control study. Neurology, 51:1110–1115.
3. Winer JB, Hughes RA, Anderson MJ, et al. (1988) A prospective study of acute idiopathic neuropathy. II. Antecedent Events. J Neurol Neurosurg Psychiatry, 51:613–618.
4. Haddon RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, et al. (1998) Electrophysiological classification of Guillain–Barré syndrome: clinical associations and outcome. Ann Neurol, 44:780–788.
5. Seneviratne U (2000) Guillain–Barré syndrome. Postgrad Med J, 76:774–782.
6. Winer JB, Hughes RAC, Osmond C (1998) A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry, 51:605–612.
7. Haddon RD, Hughes RA (2003) Management of inflammatory neuropathies. J Neurol Neurosurg Psychiatry, 74(Supp II): ii9–ii14.
8. Rees JH, Thompson RD, Smeeton NC, et al. (1998) Epidemiological study of Guillain–Barré syndrome in South-East England. J Neurol Neurosurg Psychiatry, 64:74–77.
9. The Italian Guillain–Barré Study Group (1996) The prognosis and main prognostic indicators of Guillain–Barré syndrome: a multicentre prospective study of 297 patients. Brain, 119:2053–2061.
10. Hahn AF (2001) The challenge of respiratory dysfunction in Guillain–Barré Syndrome. Arch Neurol, 58:871–872.
11. Ropper AH, Kehne SM (1985) Guillain–Barré syndrome: management of respiratory failure. Neurology, 35(II):1662–1665.
12. Ropper AH (2001) Neuromuscular respiratory failure. Presented at: The Second Biennial New York Symposium on Neurologic Emergencies and Neurocritical Care; May 19, New York City.
13. Durand MC, et al. (2006) Clinical and electrophysiological predictors of respiratory failure in Guillain–Barré syndrome: a prospective study. Lancet, 5(12):1021–1028.
14. Lawn ND, Fletcher DD, Henderson RD, Wolter TD, Wijdicks EF (2001) Anticipating mechanical ventilation in Guillain–Barré syndrome. Arch Neurol, 58(6):893–898.
15. Wijdicks EFM, Henderson RD, McClelland RL (2003) Emergency intubation for respiratory failure in Guillain–Barré syndrome. Arch Neurol, 60:947–948.
16. Mehta S (2006) Neuromuscular disease causing acute respiratory failure. Respiratory Care, 51:1016–1022.
17. Guillain–Barré syndrome Steroid Trial Group (1993) Double-blind trial of intravenous methylprednisolone in Guillain–Barré syndrome. Lancet, 341:586–590.
18. Grieg PR, Goroszeniuk D (2006) Role of computed tomography before lumbar puncture: a survey of clinical practice. Postgrad Med J, 82:162–165.
19. Tunbridge AJ, et al. (2008) Chickenpox in adults – Clinical Management. Journal of Infection, 57:95–102.
20. British National Formulary March 2009. BMJ Publishing Group and RPS Publishing.

Disclaimers

Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.