GAMBARAN KLINIK TANDA DAN GEJALA KELEMAHAN MOTORIK TERJADI AKUT

(PARAPARESIS LMN) DAN SIMETRIS, AREFLEKSIA

KELEMAHAN TERJADI, 50 % MENJELANG 2 MGG, 80% MENJELANG 3 MGG > 90 % MENJELANG 4 MGG DAN BERHENTI

KASUS RINGAN HANYA TERBATAS KEDUA TUNGKAI

KASUS BERAT TERJADI TETRAPLEGIA LMN DENGAN CEPAT DALAM WAKTU < 72 JAM ASCENDING LANDRYS PARALYSIS.

NERVI KRANIALIS DAPAT TERKENA.

GANGGUAN OTONOM : ARITMIA, MIKSI, VASOMOTOR

Jean-Baptiste Octave

Landry 1859

PLASMA EXCHANGE 4 OR 5 TREATMENTS OVER 7 TO 10 DAYS ?

FEWER LATE RELAPSES

NO ALLERGIC REACTIONS

EFFICACY SOMEWHAT BETTER DOCUMENTED

USE IN ADULTS WITH GOOD VENOUS ACCESS VERY RECENT ONSET OF SYMPTOMS (1 TO 3 DAYS) HISTORY OF SIDE EFFECTS WITH IV IG PREGNANCY CONGESTIVE HEART FAILURE RENAL INSUFFICIENCY IGA DEFICIENCY

RECOMMENDATIONS PE IS RECOMMENDED IN NON-AMBULANT PATIENTS

WITHIN FOUR WEEKS FROM ONSET (LEVEL A,

CLASS II

EVIDENCE).

PE IS RECOMMENDED FOR AMBULANT PATIENTS WITHIN TWO WEEKS FROM ONSET

(LEVEL B, LIMITED CLASS II EVIDENCE).

American academy of neurologi, 2003

IVIG PRIMARY THERAPY; 2 GM/KG TOTAL OVER 2 TO 5 DAYS

SLIGHTLY HIGHER COST

SLIGHTLY FEWER SIDE EFFECTS

EASIER TO ADMINISTER

USE IN CHILDREN RURAL SETTINGS WITH NO ACCESS TO PLASMA EXCHANGE PATIENTS WITH

DIARRHEA PRODROME INFECTIOUS DISORDERS (HIV) AUTONOMIC INSTABILITY POOR VENOUS ACCESS RELAPSES OF WEAKNESS

American actor Andy Griffithdeveloped Guillain-Barr syndrome in 1983. Griffith is seen here receiving an award at the U.S. White House in 2005

NOTABLE SUFFERERS

ANDY GRIFFITH 1983

FDR; 2003 IN A PEER REVIEW STUDY LESS LIKELY POLIOMYELITIS

WILLIAM THE REFRIGERATOR PERRY; 2008