Guillain-Barre Syndrome Research Assignment Paper (Essay Sample)

Guillain-Barre Syndrome
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The current patient is 70 years old and has had a history of alcohol abuse, diabetes mellitus, stroke/CVA, hypertension as well as residual deficit. The patient has been in hospital for prolonged period, with complicated Guillain-Barre Syndrome (GBS). He has respiratory failure, is currently weak and has been referred to physical therapy for functional assessment.
The disease process has greatly affected the patient’s independence. He has supine bed mobility, is able to sit with moderate assistance, with fair but static sitting balance. He has to use bed rails to achieve balance, thus is balance dependent. He also requires maximal assistance for transfer, and lacks ambulatory ability. The patient requires maximum assistance in carrying out activities of daily living, such as feeding and dressing. Cafasso and Reed-Guy (2015) affirm that GBS causes decreased functional ability and with time, the patient experiences decreased muscle strength, and decreased endurance. The patient’s social history reveals that he is sexually inactive. Ranjani et al. (2014) note that GBS contributes significantly to a patient’s increased fatigue level due to progressive muscle weakness, a condition that reduces mobility and independence. Ultimately, the quality of life decreases.
Loss of independence is also attributable to respiratory failure. The patient’s low CO2 level is precursor for respiratory failure. The patient’s CO2 rate is 20 mmol/L, a rate that falls below the normal range of 24-30 mmol/L (MedlinePlus, 2016). Respiratory failure inhibits effective brain functioning, which implies reduced nerve response, including muscle coordination, a condition that is seen in GBS patients.
As a primary diagnosis, GBS is linked to smoking. Smoking can be associated with GBS directly or indirectly (through diabetes mellitus, as is exhibited in the patient). Smoking aggravates glucose homeostasis and increases the risk of chronic diabetic mellitus complications, and adversely affects diabetic nephropathy (Chang, 2012). Smoking habit reduces an individual’s nerve functions and ultimately, muscle movements are affected (Chang, 2012).
Smoking not only increases the risk of developing diabetes mellitus, it also increases micro and macro-vascular complications associated with diabetes mellitus (Chang, 2012). A study done on 304 GBS patients by Wang et al. (2015) showed that type I diabetes may share systematic immune pathways with GBS. High level of fasting plasma glucose (FPG) and fibrinogen was associated with high severity of GBS due to the various infectious and inflammatory conditions, particularly inflammation of peripheral nerves as well as spinal nerve roots, conditions that are typically seen in GBS patients (Wang et al., 2015).
Another study directly linked cigarette smoking to poor functional recovery after peripheral nerve reperfusion injury. The study, by Rinker et al. (2011) found that exposure to cigarette smoke significantly reduced the recovery rate for affected individuals, such as GBS patients whose peripheral nerve had been damaged through autoimmune infections.
Diagnosis of GBS can be done by spinal tap, electromyography, or nerve conduction tests (Cafasso & Reed-Guy, 2015). Neurological conduction tests were done on the patient. The patient’s muscle strength is rated 3/5, indicating a drop in muscle ability. Cranial nerves II – XII are within normal limits, bilateral shoulder flexion, elbow and shoulder flexion is normal but wrist flexion is below NL, at 2/5. This is indicative of slow nerve and muscle response to small electrical pulses (Cafasso & Reed-Guy, 2015). Respiratory failure for the patient is linked to his low CO2 rate as revealed by metabolic diagnosis.
The diagnosis results in the nervous system being affected. The syndrome can temporarily weaken the body’s ability to control blood pressure. Consequently, the patient can experience dangerously low blood pressure when they attempt to stand up after sitting or lying down (Drugs, 2016). As the syndrome results in the immune system attacking the peripheral nervous system, the nerves connecting the brain to the rest of the body are affected thus the transmission of signals to the muscles slows down. The muscles’ ability to respond to signals sent from the brain diminishes and sensory...