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 Griffith

developed 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