Menu
Home
Log in / Register
 
Home arrow Environment arrow Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management
Source

Dysautonomia

Autonomic dysfunction in GBS is more common in the acute stage of the disease, can involve sympathetic or parasympathetic systems, and is a major cause of mortality [2]. In a study on pediatric GBS patients, hypertension and tachycardia occurred in 70 and 77% of the patients, respectively, and they were more likely with increasing motor weakness [47]. In another study on 156 GBS patients, tachycardia, hypertension, and hypotension were noted in 38, 69, and 11% of the patients, respectively [48]. Less common manifestations include transient ECG changes such as ST segment elevation and diffusely inverted T waves secondary to coronary vasospasm [49]. Careful assessment for fluctuations in blood pressure and pulse rate and appropriate treatment which may involve symptomatic treatment and even insertion of a pacemaker are therefore important aspects of the GBS care, especially during the ICU care, but also during the recovery period [1].

Gastrointestinal dysfunction was noted in 45% of a large cohort of GBS patients [48], while adynamic ileus was reported in 15% of GBS patients admitted to the ICU in another study [50]; however, the authors speculated that some of the cases could have been due to other factors such as abdominal surgery, immobility, and use of medications such as opioids.

About a quarter of GBS patients (39% of AIDP and 19% of the AMAN cases) had urinary symptoms, including urinary retention in about 10% of the cases [51, 52]. Urinary dysfunction in GBS is proposed to be caused by either hypo- or hyperactivity of lumbosacral nerves [52]. Besides incontinence and urinary retention which will require the use of a catheter, patients may develop underactive detrusor, overactive detrusor, and, to a lesser extent, hyperactive sphincter. Urinary symptoms may be persistent and affect the quality of life in the patients who have recovered from the acute phase, i.e., urinary frequency and urgency were present in one third and nocturia in half of the patients who recovered from GBS patients when these patients were followed for 6 years [53].

 
Source
Found a mistake? Please highlight the word and press Shift + Enter  
< Prev   CONTENTS   Next >
 
Subjects
Accounting
Business & Finance
Communication
Computer Science
Economics
Education
Engineering
Environment
Geography
Health
History
Language & Literature
Law
Management
Marketing
Mathematics
Political science
Philosophy
Psychology
Religion
Sociology
Travel