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Suggest Treatment For Gullain Barre Syndrome

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Posted on Mon, 23 Feb 2015
Question: My 13 year old granddaughter is in inpatient rehab following what we believe was GUillian-Barre but never got positive CSF results or confirmation via MRI. SHe seems to be making progress with rehab but has a new symptom. Her legs turned very purple while standing to brush her teeth and other skin has a mottled appearance at times. Are there ever autoimmune hematologic changes following this probable GBS variant?
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Answered by Dr. Ajay Panwar (40 minutes later)
Brief Answer:
Autoimmune etiology or as a part of neuropathy.

Detailed Answer:
Hi XXXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar, a neurologist, here to answer your query.

If your granddaughter would have presented to me as an outpatient,I would have given for her, the following explanation-

Gullain barre syndrome is a classical syndrome of 'acute onset hypotonia with arreflexic paralysis'.Its diagnosis is confirmed with nerve conduction studies.There is not much left for believing.So,if you believe that your granddaughter had GBS,it must be based on some thorough physical examination and nerve conduction studies. CSF analysis has only supportive role in diagnosis and MRI has no role(except MRI spine for ruling out acute transverse myelitis which can sometimes confuse with GBS).
Still, I presume that GBS is an established diagnosis.Then,GBS is a type of neuropathy and legs turning purple while standing along with mottled appearance of skin can occur as a result of neuropathy,likely due to autonomic neuropathy.
Though,autoimmune phenomenon may also be a cause and hence has to be ruled out.I would have advised to get the following investigations done-
1)Erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP)
2)Anti nuclear antibody(ANA)
3)antiphospholipid antibody(APLA)
4)Blood sugar-fasting and post meal
5)Autonomic function tests-Sudomotor axon reflex test

Please get the following investigations done.It will most likely bring out the cause of these symptoms.Hope I have answered your query.If you have some follow up queries,I shall be glad to answer else,please close the thread,rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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Suggest Treatment For Gullain Barre Syndrome

Brief Answer: Autoimmune etiology or as a part of neuropathy. Detailed Answer: Hi XXXXXX, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar, a neurologist, here to answer your query. If your granddaughter would have presented to me as an outpatient,I would have given for her, the following explanation- Gullain barre syndrome is a classical syndrome of 'acute onset hypotonia with arreflexic paralysis'.Its diagnosis is confirmed with nerve conduction studies.There is not much left for believing.So,if you believe that your granddaughter had GBS,it must be based on some thorough physical examination and nerve conduction studies. CSF analysis has only supportive role in diagnosis and MRI has no role(except MRI spine for ruling out acute transverse myelitis which can sometimes confuse with GBS). Still, I presume that GBS is an established diagnosis.Then,GBS is a type of neuropathy and legs turning purple while standing along with mottled appearance of skin can occur as a result of neuropathy,likely due to autonomic neuropathy. Though,autoimmune phenomenon may also be a cause and hence has to be ruled out.I would have advised to get the following investigations done- 1)Erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) 2)Anti nuclear antibody(ANA) 3)antiphospholipid antibody(APLA) 4)Blood sugar-fasting and post meal 5)Autonomic function tests-Sudomotor axon reflex test Please get the following investigations done.It will most likely bring out the cause of these symptoms.Hope I have answered your query.If you have some follow up queries,I shall be glad to answer else,please close the thread,rate it and write a review. Dr.Ajay Panwar, MD,DM(Neurology)