Definitions |
Guillain-Barre syndrome (GBS) is an immune-mediated, acute inflammatory demyelinating polyneuropathy (AIDP). Condition commonly follows a viral or mycoplasmal illness affecting the upper respiratory or alimentary tracts. Other antecedent events include certain vaccinations. Immune responses directed toward the infecting organisms likely cross-react with neural tissues including Schwann cell surface membrane (resulting in AIDP) or axonal membrane (acute axonal forms). GBS is usually characterized by: weakness or paralysis affecting more than one limb, usually symmetrically; loss of tendon reflexes; and increased cerebrospinal fluid (CSF) protein without pleocytosis. Other features may include: motor and sensory involvement; facial or cranial nerve involvement; and electrophysiologic evidence of demyelination. Acute form of GBS has a typically rapid evolution from hours to days, usually reaching maximum level of weakness within four weeks. Condition is classified as chronic inflammatory demyelinating polyneuropathy (CIDP) if patient's symptoms continue to progress beyond 4 weeks, or relapses occur. Peak disability in CIDP usually occurs in two months.
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definition |
Guillain-Barre syndrome (GBS) is an immune-mediated, acute inflammatory demyelinating polyneuropathy (AIDP). Condition commonly follows a viral or mycoplasmal illness affecting the upper respiratory or alimentary tracts. Other antecedent events include certain vaccinations. Immune responses directed toward the infecting organisms likely cross-react with neural tissues including Schwann cell surface membrane (resulting in AIDP) or axonal membrane (acute axonal forms). GBS is usually characterized by: weakness or paralysis affecting more than one limb, usually symmetrically; loss of tendon reflexes; and increased cerebrospinal fluid (CSF) protein without pleocytosis. Other features may include: motor and sensory involvement; facial or cranial nerve involvement; and electrophysiologic evidence of demyelination. Acute form of GBS has a typically rapid evolution from hours to days, usually reaching maximum level of weakness within four weeks. Condition is classified as chronic inflammatory demyelinating polyneuropathy (CIDP) if patient's symptoms continue to progress beyond 4 weeks, or relapses occur. Peak disability in CIDP usually occurs in two months.
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Scope Statement |
NOTE: Cases of interest can be retrieved without the algorithm; however, its application may be most helpful when it is expected that a large number of cases will be retrieved by broad scope terms. Please refer to the CIOMS WG documentation for detailed information on the algorithm, including category term lists. Category A (Narrow scope): terms representing GBS and sub-types. Category B (Broad scope): very commonly seen signs and symptoms from well-documented cases of GBS and its variants based on testing. Most terms relate to paresthesias, hypoesthesias and neuropathies. Category C (Broad): commonly seen signs, symptoms and diagnostic laboratory work based on testing. Category D (Broad): less frequently seen signs, symptoms and diagnostic laboratory work based on testing and signs, symptoms and diagnostic laboratory work that may be seen in GBS and its variants, but were not observed in the databases tested. Cases to be selected for further review would include any cases meeting any one of the following criteria: 1) at least one of the PTs listed for Category A (narrow scope) or 2) any case reporting at least two PTs from Category B or 3) any case reporting at least one PT from Category B and at least one PT from Category C or 4) any case reporting at least one PT each from Categories B, C and D. Certain drugs with high numbers of reports for terms such as paresthesias, hypoesthesias and muscular weakness, do capture more noise with the algorithm 2B and 1B+1C. It is recommended that for products such as these algorithm 1B + 1C + 1D is used is as it can eliminate much noise resulting in false hits.
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SMQ SOURCE |
1) Textbook of Clinical Neurology, 2nd Edition, pp1085-1089, 2003. 2) Cecil Textbook of Medicine, 22nd Edition, pp 2379-2381, 2004. 3) Harrison's Internal Medicine, 16th Edition, pp 2513-2518, 2005. 4) Ferri F. Guillain-Barre syndrome. Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2006 ed. Available at http://home.mdconsult.com/das/book/58437071-2/view/1302. 5) Cha-Kim A. Guillain-Barr? syndrome. eMedicine. Available at http://www.emedicine.com/pmr/topic48.htm. Accessed May 22, 2006. 6) Aarli JA. Role of Cytokines in Neurologic Disorders. Current Medicinal Chemistry. 2003; 10:1931-1937. 7) Stedman's Medical Dictionary. 26th edition. Williams & Wilkins. Baltimore, MD; 1995.
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