Federal University Teaching Hospital, Owerri, Nigeria.
Bingham University Teaching Hospital, Jos, Nigeria.
Medicine (Baltimore). 2024 Jul 26;103(30):e38890. doi: 10.1097/MD.0000000000038890.
Guillain-Barré Syndrome (GBS) is a rare but potentially life-threatening neurological disorder characterized by acute onset ascending paralysis and sensory abnormalities. This article provides a comprehensive overview of GBS, covering its epidemiology, etiology, clinical presentation, diagnostic evaluation, management and treatment, prognosis, psychosocial impact, recent advances in research, public health implications, and ethical considerations. Epidemiological data reveal variations in GBS prevalence, incidence rates, and geographical distribution influenced by climate, infectious disease prevalence, and genetic susceptibility. Etiological factors include preceding infections, vaccinations, and autoimmune mechanisms, although the precise pathophysiology remains incomplete. Clinical presentation encompasses prodromal symptoms, motor deficits, sensory abnormalities, autonomic dysfunction, and variants such as Miller-Fisher Syndrome and Bickerstaff brainstem encephalitis. Neurological examination findings include weakness, paralysis, sensory deficits, and reflex changes, while autonomic dysfunction manifests as cardiovascular, respiratory, and gastrointestinal symptoms. Diagnostic evaluation relies on clinical criteria, laboratory tests (e.g., cerebrospinal fluid analysis, nerve conduction studies), and consideration of differential diagnoses. Management strategies encompass supportive care, immunomodulatory therapies (e.g., intravenous immunoglobulin, plasma exchange), and rehabilitation interventions to optimize functional outcomes and promote recovery. Prognosis varies depending on clinical features, treatment response, and complications such as respiratory failure and autonomic instability. Psychosocial impact encompasses psychological effects on patients and caregivers, highlighting the importance of coping strategies and support systems. Recent advances in research focus on emerging treatments, genetic predisposition, and biomarker discovery, offering promise for improving GBS outcomes. Public health implications include vaccination safety concerns and healthcare system considerations for GBS management. Ethical considerations encompass patient autonomy, resource allocation, and end-of-life decision-making.
格林-巴利综合征（GBS）是一种罕见但潜在危及生命的神经系统疾病，其特征为急性起病的上升性瘫痪和感觉异常。本文全面概述了 GBS，涵盖其流行病学、病因、临床特征、诊断评估、治疗和管理、预后、心理社会影响、研究新进展、公共卫生意义和伦理考虑。流行病学数据显示，GBS 的患病率、发病率和地理分布存在差异，受气候、传染病流行和遗传易感性的影响。病因包括前驱感染、疫苗接种和自身免疫机制，尽管确切的病理生理学仍不完整。临床特征包括前驱症状、运动障碍、感觉异常、自主神经功能障碍以及米勒-费舍尔综合征和比克斯特夫脑干脑炎等变异型。神经检查发现包括无力、瘫痪、感觉缺失和反射变化，而自主神经功能障碍表现为心血管、呼吸和胃肠道症状。诊断评估依赖于临床标准、实验室检查（如脑脊液分析、神经传导研究）和鉴别诊断的考虑。管理策略包括支持性护理、免疫调节治疗（如静脉注射免疫球蛋白、血浆置换）和康复干预，以优化功能结局并促进恢复。预后取决于临床特征、治疗反应以及呼吸衰竭和自主神经不稳定等并发症。心理社会影响包括对患者和照护者的心理影响，突出了应对策略和支持系统的重要性。研究新进展集中在新兴治疗方法、遗传易感性和生物标志物发现上，为改善 GBS 结局带来了希望。公共卫生意义包括疫苗接种安全性关注和 GBS 管理的医疗保健系统考虑。伦理考虑包括患者自主性、资源分配和临终决策。
