Guillain Barre Syn treatment

Posted On February 15, 2020

Treatment:

  • IVIG
    • 0.4 gram/kg/day x 5 days
    • less likely to discontinue rx compared with plasma exchange
    • unproven: more severe disease may benefit from long duration of ivig
    • unproven: repeat dose may help, controversial
    • side effect: aseptic meningitis, rash, acute kidney disease
  • Plasma exchange
    • 4 to 6 exchange over 8-10 days
    • Main complications: hypotension, sepsis, problem with iv access
  • Compare both:
    • Similar results
    • Combining both no advantage
  • Supportive care
  • Respiratory failure
  • Blood pressure
    • fluctuating BP
    • orthostatic hypotension
  • Arrhythmia
    • sinus tachycardia most common
    • bradycardia also common
  • Bowel and bladder care
    • ileus
    • urinary retention
  • Neuropathic Pain very common
    • consider gabapentin, pregabalin

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