Changes

=Autoimmune Disorders=

=Autoimmune Disorders=

==Guillain-Barré syndrome==

==Guillain-Barré syndrome==

*H&P: Ascending paralysis typically following a respiratory or GI (e.g. campylobacter) infection. Also known as Acute Inflammatory Demyelinating Polyneuropathy (AIDP). Lasts 2-4 weeks. If it lasts > 8 weeks, think CIDP, C for Chronic. '''Hyporeflexia and parasthesias'''.

*H&P: Ascending paralysis that has an onset of '''days''', typically following a respiratory or GI (e.g. campylobacter) infection. Also known as Acute Inflammatory Demyelinating Polyneuropathy (AIDP). Lasts 2-4 weeks. If it lasts > 8 weeks, think CIDP, C for Chronic. '''Hyporeflexia and parasthesias'''.

*Dx: Clinical. Can get EMG which shows slow conduction (due to demyelination). LP will show albuminocytologic dissociation (elevated protein, normal WBCs). '''Differential includes transverse myelitis, which is more likely to have a sensory level and bowel/bladder involvement. Get an MRI to rule it out if diagnosis is unclear'''

*Dx: Clinical. Can get EMG which shows slow conduction (due to demyelination). LP will show albuminocytologic dissociation (elevated protein, normal WBCs). '''Differential includes transverse myelitis, which is more likely to have a sensory level and bowel/bladder involvement, and tic paralysis which progresses over hours'''. Get an MRI to rule it out if diagnosis is unclear'''

*Tx: Usually self resolves. '''Frequently monitor vital capacity at bedside.''' '''Plasmapheresis or IVIG''' speed up resolution of symptoms '''and are indicated in patients who are nonambulatory and had symptom onset within last 4 weeks'''.

*Tx: Usually self resolves. '''Frequently monitor vital capacity at bedside.''' '''Plasmapheresis or IVIG''' speed up resolution of symptoms '''and are indicated in patients who are nonambulatory and had symptom onset within last 4 weeks'''.