Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be going through Gillian Barre syndrome.

And if you want to follow along with written notes on this topic, as always you can follow along at zero definals.com slash Gillian Barre or in the neurology section of the Zero Definal's Medicine book.

So let's get straight into it.

Gillen-Barray syndrome is an acute paralytic polyneuropathy,

and it affects the peripheral nervous system.

And it causes an acute, meaning quite quick, onset, symmetrical, affecting both sides equally, ascending weakness.

So it's weakness that is coming up from the feet upwards.

It can also affect the sensory nerves causing a sensory neuropathy.

It's usually triggered by an infection and is

particularly associated with gastroenteritis caused by campylobacter jejuni or infection with

cytomegalovirus or Epstein-Barr virus. So what's the path of physiology? Gileumare is thought

to occur due to a process called molecular mimicry.

And this is where the B cells of the immune system create antibodies against the antigens on the pathogen

that's causing the preceding infection.

So if they've got a campylobacter gastroenteritis, the B cells of the immune system create antibodies against that canpilobacter.

And these antibodies also match proteins on the nerve cells.

They may target proteins on the myelin sheath of the motor nerve or on the nerve axon itself. And this damage to the nerve cells,

because of these antibodies against the nerve cells, create the neuropathy and the symptoms.

So how does Gillianbari syndrome presents? Well, it presents with a symmetrical ascending weakness,

which starts from the feet and moves up the body. There will be reduced reflexes because it's a

peripheral neuropathy. There may be peripheral loss of sensation or neuropathic pain,

...