Guillain barre syndrome~~臨床少見多發性神經病變須血漿置換治療－woocy的秘密基地

GBS-- Guillain barre syndrome

Guillain-Barré syndrome (GBS) is an important cause of acute neuromuscular paralysis. Molecular mimicry and across-reactive immune response play a crucial part in its pathogenesis, at least in those cases with a preceding.Campylobacter jejuni infection and with antibodies to gangliosides. The type of preceding infection and patient-related host factors seem to determine the form and severity of the disease. Intravenous immunoglobulin (IVIg) and plasma exchange are eff ective treatments in GBS; mainly for practical reasons, IVIg is the preferred treatment. Whether mildly aff ected patients or patients with Miller Fisher syndrome also benefi t from IVIg is unclear. Despite medical treatment, GBS often remains a severe disease; 3–10% of patients die and 20% are still unable to walk after 6 months.In addition, many patients have pain and fatigue that can persist for months or years. Advances in prognostic modelling have resulted in the development of a new and simple prognostic outcome scale that might also help to
guide new treatment options, particularly in patients with GBS who have a poor prognosis. Guillain-Barre' 症候群是一種感染後多發性神經炎，發生率是每十萬人中有1 至1. 5人，好發年齡是16歲至25歲，其次是40歲至60歲，以4歲至10歲的兒蜜較易受感染。Guillain-Barre' 氏症候鮮是一種急性、單一病程，侵犯周邊神經與腦神經的疾病，又稱之為多發神經根炎。患者運動、感覺、自主、以及腦神經傳導路徑，被巨大吞噬細胞浸蝕破壞髓鞘，阻礙神經傳導。臨床表徵首先出現跌倒、步態不穩，由下肢侵犯，漫延至上肢、軀幹、及頸部肌肉，最後腦神經受到侵犯，導致雙側臉部肌肉無力，吞嘸障礙、發音困難。若呼吸肌肉受侵犯，會導致呼吸肌無力，氣鶴交換不足，需利用人工呼吸器來輔助呼吸。