Pediatric Guillain-Barre Syndrome
Introduction
Introduction to Pediatric Green Barley Syndrome Pediatric Guillain-Barre syndrome refers to an acute onset, characterized by nerve root and peripheral nerve damage, accompanied by a syndrome characterized by protein-cell separation in cerebrospinal fluid. Also known as multiple radiculitis. basic knowledge The proportion of illness: 0.005% Susceptible people: children Mode of infection: non-infectious Complications: pneumonia, acne, thrombosis, pulmonary embolism, urinary retention, anxiety, depression
Cause
Pediatric Guillain-Barre Syndrome
1. The etiology and pathogenesis of pediatric Guillain-Barre syndrome have not yet been fully elucidated. It is generally believed that there is a history of non-specific infection and vaccination history before the onset, and delayed allergic reactive immune disease. There is an incubation period between infection and onset. The immune response acts on Schwann cells and myelin sheaths of the peripheral nerves, resulting in localized segmental demyelination with infiltration of perivascular and endometrial lymphocytes, monocytes, and macrophages.
2. Axonal degeneration and fragmentation can be seen in severe cases. Myelin can regenerate, and both myelin loss and regeneration can be seen in the same nerve fiber. Sometimes see the meningeal inflammatory response, spinal cord hemorrhage, anterior horn cells and cranial nerve motor nuclear degeneration. The muscles are denervated.
3. The clinical symptoms are a history of upper respiratory tract or digestive tract infection 1-4 weeks before onset, or a history of vaccine vaccination. It can be affected in all seasons, and there are many in summer and autumn.
4, Chinese medicine believes that children with Guillain-Barre syndrome belongs to the category of "stagnation syndrome." The cause is mostly due to dampness and damp heat; the pathogenesis is hot and humid invading the meridians, the venous veins are flaccid, and the liver, kidney and spleen are injured for a long time, resulting in loss of blood and muscles and muscles, and the treatment is mostly to clear away heat and dampness. Shujin, Huoxuetongluo, Yiqi Jianpi, nourishing liver and kidney, cloth fine sputum and other methods.
Prevention
Pediatric Green Barley Syndrome Prevention
Stay optimistic and happy. Long-term mental stress, anxiety, irritability, pessimism and other emotions will make the balance of the cerebral cortex excitatory and inhibition process imbalance, so you need to maintain a happy mood.
Complication
Pediatric Guillain-Barre syndrome complications Complications pneumonia acne thrombosis pulmonary embolism urinary retention anxiety disorder depression
Because patients with this disease often have prolonged bed rest, it is easy to have complicated pneumonia, sepsis, hemorrhoids, deep vein thrombosis, pulmonary embolism, urinary retention, anxiety, depression and other symptoms. And if the lesion involves the respiratory muscles can be fatal.
Symptom
Pediatric Guillain-Barre Syndrome Symptoms Common symptoms Hypokalthemia reflexes disappeared dyspnea fasciculation acne ataxia limbs symmetry soft palate muscle beating tachycardia cranial nerve palsy dysphagia
Pediatric Guillain-Barre syndrome is clinically generally 1 to 3 weeks after infectious disease, sudden onset of intense nerve root pain (to the waist, shoulders, neck, and lower extremities), acute progressive symmetry of limb soft palate, subjective sensory disturbance The sputum reflex is weakened or disappeared as the main symptom. Its specific performance is:
(1) Sensory disturbance: generally lighter, starting from the numbness and acupuncture of the extremities. There may also be a sore-like feeling of sensation, allergies or disappearance, as well as spontaneous pain, tenderness of the front wall muscles and gastrocnemius muscles. Occasionally, segmental or conduction beam dysfunction can be seen.
(2) dyskinesia: limbs and trunk tendons are the main symptoms of this disease. Generally starting from the lower limbs, gradually affecting the trunk muscles, the upper limbs and the cranial nerves, from one side to the other. The disease usually develops to a peak within 1 to 2 weeks. The sputum is generally more proximal than the distal end and has low muscle tone. If breathing, swallowing, and pronunciation are involved, it can cause spontaneous paralysis, swallowing, and difficulty in pronunciation, which can be life-threatening.
(3) Emission disorder: The quadriplegia reflex is mostly symmetry weakening or disappearing, and the abdominal wall and cremaster reflex are normal. A small number of patients may have pathological reflexes due to vertebral body involvement.
(4) autonomic dysfunction: often sweating and sweaty odor in the initial or recovery period, which may be the result of stimulation of the sympathetic nerve. A small number of patients may have short-term urinary retention at the beginning, which may be caused by temporary imbalance of autonomic function that governs the bladder or damage to the spinal nerves that innervate the external sphincter; frequent bowel movements; some patients may experience blood pressure instability, tachycardia, and electrocardiogram Abnormal, etc.
(5) Cranial nerve symptoms: Half of the patients have cranial nerve damage, and the peripheral ridges of the tongue, pharynx, vagus nerve and one or both sides of the nerve are more common. Followed by eye movement, pulley, and abduction nerve. Occasionally, optic nerve head edema may be caused by inflammatory changes in the optic nerve itself or cerebral edema. It may also be associated with a significant increase in cerebrospinal fluid protein, obstructing arachnoid villi and affecting the absorption of cerebrospinal fluid.
Examine
Examination of children with Guillain-Barre syndrome
Cerebrospinal fluid protein, electrocardiogram, blood routine, electromyography, neurological cytology.
Diagnosis
Diagnosis and diagnosis of Pediatric Guillain-Barre syndrome
diagnosis
Diagnosis of the disease according to the sudden onset of symmetry of the infectious disease is the distal limbs of the sensory, motor and nutritional disorders and the disappearance of tendon reflex can be diagnosed.
Differential diagnosis
1, polio: fever a few days later, when the body temperature does not fully return to normal, hemorrhoids often occur, one side of the lower limbs, no sensory disturbances and cranial nerve involvement. CSF cell protein separation was observed 3 weeks after the disease, and attention was paid to the identification.
2, hypokalemia paralysis: GBS more pre-infection history and autoimmune response, hypokalemia type periodic paralysis has a history of hypokalemia, hyperthyroidism. The former is acute or subacute onset, progressing no more than 4 weeks, quadriplegia often starts from both lower extremities, the proximal end is more obvious, the latter onset is fast (hours to 1 day), recovery is fast (2~3 days,) limbs Flaccid phlegm. GBS may have respiratory muscle paralysis, cranial nerve damage, sensory disturbance (terminal type) and pain, hypokalemia type periodic paralysis. GBS cerebrospinal fluid protein cell separation, electrophysiological examination early F wave or H reflection delay, motor NCV slow, hypokalemia type periodic normal, electrophysiological examination EMG potential amplitude decreased, electrical stimulation can be unresponsive. GBS blood potassium is normal, hypokalemia type periodic blood potassium is low, potassium supplementation is effective.
3, functional : according to neurological signs are not fixed, sputum reflexes active and spiritual incentives.
