| Sažetak | Guillain-Barreov sindrom ili akutna upalna poliradikuloneuropatija rijetka je autoimuna bolest koja zahvaća periferni živčani sustav. Obično nastaje nakon prvobitne pojave bakterijske ili virusne infekcije, ali i zbog kirurških zahvata, cijepljenja i sl. zbog čega dolazi do autoimune reakcije koja dovodi do oštećenja mijelina ili aksona živca. Najčešće se spominju infekcije s uzročnicima: campylobacter jejuni, citomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae itd. Sindrom se manifestira progresivnom, simetričnom mišićnom slabošću sa oslabljenim ili odsutnim mišićnim refleksima. Tijek bolesti varira. Može se raditi o blažoj kliničkoj slici, a može dovesti i do tetraplegije i respiratornog zatajenja. Postoji nekoliko podtipova ovoga sindroma koji se razlikuju po kliničkoj slici, a može se raditi o senzomotornom, dominantno senzornom ili dominantno motoričkom obliku bolesti. Dijagnoza bolesti temelji se na kliničkoj slici, provođenju lumbalne punkcije koja ukazuje na povišenu razinu proteina u likvoru i EMNG nalazu, a liječenje provodimo primjenom plazmafereze i imunoglobulina. Proces fizioterapije razlikuje se ovisno o tome je li oboljeli u akutnoj ili subakutnoj fazi bolesti. U akutnoj fazi provodi se identifikacija oštećenja, ograničenja aktivnosti i restrikcija participacije. Uzimaju se podatci o mogućnosti komunikacije, gutanja, prehrani, psihološkom stanju bolesnika te lijekovima koje uzima. Radi se na održavanju opsega pokreta i prevenciji kontraktura te se primjenjuju pasivne, aktivno-potpomognute i aktivne vježbe, mobilizacija prsnog koša, zdjelice i čeljusti. U subakutnoj fazi i kada je bolesnik dovoljno stabilan može se započeti sa intenzivnom rehabilitacijom. Iako se radi o teškoj i dugotrajnoj bolesti, uporna fizikalna terapija pokazala je veliki učinak u rehabilitaciji bolesnika te njihovom povratku svakodnevnim aktivnostima. |
| Sažetak (engleski) | Guillain-Barre syndrome or acute inflammatory polyradiculoneuropathy is a rare autoimmune disease that affects the peripheral nervous system. It usually occurs after the initial appearance of a bacterial or viral infection, but also due to surgery, vaccination, etc., which leads to an autoimmune reaction that leads to damage to myelin or nerve axons. Most commonly infections are caused by: campylobacter jejuni, citomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, etc.. The syndrome is manifested by progressive, symmetrical muscle weakness with weakened or absent muscle reflexes. The course of the disease varies. It can be a milder clinical picture, and can also lead to tetraplegia and respiratory failure. There are several subtypes of this syndrome that differ in the clinical picture, and they can be sensorimotor, predominantly sensory or predominantly motor form of the disease. The diagnosis of the disease is based on the clinical picture, the implementation of lumbar puncture, which indicates an elevated level of protein in the cerebrospinal fluid and EMNG findings, and the treatment is carried out using plasmapheresis and immunoglobulin. The process of physiotherapy differs depending on whether the patient is in the acute or subacute phase of the disease. In the acute phase, impairment, activity restrictions and participation restrictions are identified. Data is taken on the possibility of communication, swallowing, diet, the psychological state of the patient and the medication he is taking. We are working on maintaining the range of motion and preventing contractures, and applying passive, active-assisted and active exercises, mobilization of the chest, pelvis and jaw. In the subacute phase and when the patient is stable enough, intensive rehabilitation can begin. Although it is a severe and long-lasting disease, persistent physical therapy has shown a great effect in the rehabilitation of patients and their return to daily activities. |
