GBS Clinical Management

Does GBS affect the PNS or CNS?

PNS

Is GBS symmetrical or asymmetrical?

symmetrical

Which of the following describes the typical pt presentation of GBS, ascending or descending paralysis?

ascending

What is the pattern of return of function for pts with GBS?

proximal to distal return

T or f: Long term deficits from GBS most likely include distal weakness

True

Pts with GBS have better recovery with what factor?

no CN involvement

T or F: IV immunoglobulins reduce the severity & sx of acute GBS

True

What is GBS aka?

acute inflammatory demyelinating polyradiculoneuropathy (AIDP)

T or F: GBS involves demyelination of nerves, specifically affecting the oligodendrocytes

False; affects Schwann cells

How quickly can GBS progress to max paralysis? How long can max paralysis last?

progresses over 24-72hours

max paralysis could last 1-3 weeks

What is the most common long term deficit for GBS pts?

anterior tibial and calf musculature weakness

80% of GBS pts will become ambulatory in how many months?

6 months

Are there sensory, motor, or both types of deficits with GBS?

both

How long does GBS develop after getting COVID?

11 days

What are the precautions for GBS?

1. fatigue

2. overuse

3. respiratory issues

4. fall risk

5. aspiration risk

6. autonomic sx

7. sensory integrity

What autonomic sx should be looked out for?

-arrythmia

-tachycardia

-OH

-fluctuations in BP

-urinary retension

When should ambulation with GBS pts begin?

when LE muscle grade is 3/5 or above

What are the parts of the GBS disability scale?

0=normal

1= minimal s&s, able to run

2=ambulate indep. (can't run)

3=able to walk 5m with aid

4=bed bound (or WC)

5=requires assisted respiration

6=death

Which objective & outcome measures should be used during a PT exam?

-muscle strength

-5xSTS

-sensory integrity

-VAS

-airway clearance

-aerobic capacity

-fatigue severity scale

-ROM

What are general considerations for POC for GBS?

-optimize muscle use at tolerable pain level

-consider the pt's current level of recovery and only do what's safe

-use supportive equipment and functional adaptation if residual impairments continue

Can you provide resistance if a GBS pt is 3/5 on initial screen?

yes