Peripheral Nerve Disorders

What is Bell's palsy and What are the causes.

It is the acute unilateral inflammation of Cranial Nerve VII. It is caused viruses (Typically HSV-1), Stress, Pregnancy, Cold, infection, diabetes, and immune suppression.

Symptoms of Bell's Palsy

ALL SYMPTOMS UNIALTERAL. Facial Weakness/Paralysis, Inability to close eye, Drooling, altered taste, Hyperacusis (Heightened sensitivity in ear), Dry mouth, increased tear production, inability to smile.

What condition can Bell's Palsy mimic?

Stroke

What is the care plan for Bell's palsy.

Stroke assessment, healthy history, and assessment. Assess for eye damage risk if unable to close eye. If unable, eyepatch, artifical tears, eye lubrication ointment at night, and sunglasses. As well as facial expressions (practice), and possible assitance and education with chewing and swallowing.

What medications are common for Bell's Palsy

Prednisone (Deltasone), Acylovir (Zovirax), Artifical tears, lubricating ointment, Acetaminophen, Ibuprofen.

What is Guillian-Barre Syndrome

An acute autoimmune disorder where the body attacks the myelin sheath of peripheral nerves, leading to muscle weakness, sensation abnormalities, and sometimes paralysis.

What causes Guillian-Barre Syndrome

It is triggered by an infection.

What are the main symptoms of Guillian-Barre Syndrome

Respiratory failure (in severe cases), Weakness and ascending paralysis. Arflexia, parasthesia, autonomic dysfunction (hypo/hypertension), muscle pain, urinary retention or incontinence, facial and bulbar weakness.

How long after onset do Guillian-Barre Syndrome symptoms peak.

Typically 2 weeks after onset.

How is Guillian-Barre Syndrome diagnosed.

A lumbar puncture with a normal WBC, and elevated protein level. EMG with slow nerve conductance. Also history of recent infection

What is the care plan for Guillian-Barre Syndrome

Maintain and monitor the airway and respiratory functions. Watch Intake/Output for urinary retention. Watch autonomic functions. Assist mobility if needed.

What is the treatment for Guillian-Barre Syndrome and how long can it take for them to be effective.

Plasmapheresis and IV Immunoglobulin (Within 2 weeks of onset). Can take weeks to months for recovery.

Can Plasmapheris and IV Immunoglobulin be given together? Why or Why not?

These cannot be given together as plasmapheris will remove antibodies from the plasma. If given together you are removing the antibodies just infused from IV Immunoglobulin.