guillain barre
paralysis of skeletal muscles
guillain barre symptoms
- peripheral tingling/numbness
- progressively ascending muscle paralysis
* ground to brain
causes of guillain barre
- upper respiratory illness
- influenza
- measles
- mumps
- hep A/B
myasthenia gravis
excessive muscle weakness
*mind to ground
mysthenia gravis symptoms
- muscular weakness
- double vision
- drooping of the eyelids
- weakness in face/jaw/neck
- difficulty speaking/swallowing/chewing
tensilon test
to confirm MG
intravenous adm of tensilon will show immediate improvement in muscle weakness
GB/MG PFT
decreased VC RV FRC TLC
GB/MG xrays
- atelectasis
2. normal w appropiate ventilatory support
GB/MG management
- monitor vital sings
- monitor VC, MIP
- lung expansion (IS, deep breathing/cough, CPT)
- O2 therapy *may be refractory to hypoxemia
myasthenia gravis meds
anticholinesterase agents- improve muscle strength
- neostigmine
- pyridostigmine
*care not to overmedicate
drug overdose signs/symtoms
- marked respiratory depression
- confusion, hallucinations, delirium
- comatose
- convulsions/seizures
tx for drug oversode
narcan IM/IV
muscular dystrophy diagnosis
- enzyme testing
- elevated CK indicate damaged muscles - electromyography (EMG)
- needle electrode measures electrical activity in muscle tissue - genetic testing
assessment for neuromuscular disorders
remember to assess electrolytes
tetanus
lockjaw
tx for tetanus
endotracheal intubation a priority
positive tensilon test
administer neostigmine/mestinon
worsen after tensilon test
reverse with atropine
