Also known as Guillain-Barré Syndrome, it is a severe and common disease of the nervous system. The main lesions occur in the spinal nerve roots and spinal nerves, which may also involve cranial nerves. It is associated with viral infections or autoimmune reactions. The clinical manifestations include acute, symmetrical, flaccid limb paralysis.

bubble_chart Diagnosis

1. History and Symptoms:

Several days before the onset, there may be a history of cold exposure, upper respiratory tract, or digestive tract infection. The limbs exhibit acute, symmetrical, flaccid paralysis, often starting from the lower limbs.

2. Physical Examination Findings:

Cranial nerve involvement may manifest as facial and tongue paralysis, impaired eye movement, and bulbar palsy. Early symptoms may include sensory abnormalities such as limb numbness and pain, muscle tenderness, and a positive straight leg raise test. Muscle strength declines, muscle tone decreases, tendon reflexes weaken or disappear, and muscle atrophy occurs. In severe cases, involvement of the intercostal muscles and diaphragm may lead to respiratory muscle paralysis, which is life-threatening.

3. Auxiliary Examinations:

1. Cerebrospinal fluid examination: Elevated protein levels with normal or grade I elevated cell counts, showing "protein-cell dissociation."

2. In cases of concurrent infection, white blood cell count and differential may increase. Electromyography reveals lower motor neuron damage, with reduced motor unit potentials during the acute phase, prolonged latency, and slowed MCV and SCV.

bubble_chart Treatment Measures

1. For those with respiratory muscle paralysis, tracheotomy should be performed as early as possible. Strengthen airway management, maintain airway patency, and ensure effective artificial respiration.

3. Neurotrophic drugs: citicoline 250mg intramuscular injection once daily, mecobalamin 20mg intramuscular injection once daily, nerve growth factor 10 million units intramuscular injection once daily. High-dose intravenous immunoglobulin (200-400mg/kg/day) shows good efficacy. High-dose oral vitamin supplements.

4. Administer antibiotics for concurrent infections.

5. Maintain water-electrolyte balance and enhance nutrition. For patients with bulbar paralysis, provide nasogastric feeding with high-protein, high-calorie diets.

6. During the convalescence stage, traditional Chinese medicinals, acupuncture, and physiotherapy can be combined to promote functional recovery of the affected limbs. {|105|}