We had some great input and debate from students on this question of the day from a nero exam. Congrats to those of you who correctly guessed it as Guillain Barre Syndrome.
Now check your hypothesis against the clinical signs:
| Tone | Any sign of UMN lesion or hypotonia (cerebellar?) NO
But there is some reduced tone in the left arm: |
| Power | He is weak and its come on over the past few days: this is classical of GBS: an ascending peripheral motor and sensory poylneuropathy. |
| Coordination | Normal: as expected |
| Sensation | Normal: So can it still be GBS??? YES! The sensory signs are often vary vague: there may be only back |
| Reflexes | Clinical tip: no reflexes Auggests a lower motor neurone problem. Could it me MND? Very unlikely: there’s only LMN signs and the onset of the illness is too acute. |
| Other things | GBS: measure the Forced Vital Capacity:
If this is low: the patient may need ventilation. Also remember: cardiac conduction deficits (monitor the patient on Remember FVC monitoring in GBS. |