​Pathology - Guillain-Barre Syndrome

​Pathology - Guillain-Barre Syndrome 
Typically follows a flu-like viral infection (such as EBV, HSV, CMV), but can also be linked to surgical operations and bacterial infections (Mycoplasma, Campylobacter).

Study of the biological processes that lead to disease. A viral infection triggers an immunological response mediated by T-cells, leading to the demyelination of peripheral nerves.

Peripheral nerves show infiltration by lymphocytes and macrophages in the endoneurium and perivenular areas, along with segmental demyelination.

Clinical Symptoms and Signs 
Progressive muscle weakness and paralysis starting in the furthest lower limbs; lack of deep tendon reflexes; occasional sensory loss in limbs; facial weakness in both sides; aberrant autonomic function (irregular heartbeats, unstable blood pressure).
May advance to respiratory failure or develop into chronic inflammatory demyelinating polyradiculoneuropathy.
Laboratory results: Lumbar puncture reveals albuminocytologic separation in the cerebrospinal fluid, characterized by a significant increase in protein content with only a slight rise in cell count.

Therapies 
Treatment includes plasmapheresis, intravenous immunoglobulin, and supportive treatment such as respiratory assistance till recovery.
Most patients have recovery within weeks to months, whereas 10%-20% are left with enduring disability.

Postinfectious encephalitis may occur after viral infections such as chicken pox, rubella, measles, and mumps, and is identified by temporary, extensive demyelination.