GULLAIN- BARRE SYNDROME(GBS)=  . GBS is commnest acute polynetropathy.  It affects people at any age.   Usually follows viral infection.  PATHOLOGY= 1-it is a monophasic immunologically mediated inflammatory disorder of peripheral nerve. 2-multifocal demyelination with inflammation results in coduction block. 3-severe forms show sec. axonal degeneration. CLINICAL FEATUSES= 1- acute disorder, progress for few days. 2-predominent motor neuropathy. 3-distal paraesthesias wid mildly disturbed joint postion sense. 4- motor paralysis is more striking n symmetrical, involving proximal muscles. It begins in legs, progressing over several days to involve arms, face n eyes.   5- reflexes r absent. 6- bulbar muscle weakness. 7- resp. paralysis n autonomic disturbances  occur in few.
INVESTIGATIONS= 1-CSF show raised proteins,..2-nerve conduction velocity is slow.    3-acute intermittent porphyria, post-diptheritic neuritis n drug induced acute polyneuropaties have to b ruled out.   TREATMENT= 1-maintainance of airway, breathing n circulation.  2-ventilate if pt. feels resp. failure.  3- monitor pulse, blood pressure, cardiac activity using a cardiac monitor if pt have instability. 4-plasmapheresis n gamma-gloubulins 0.4 g/kg/day for 5 days. 

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