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Chapter 5 CARE OF THE PATIENT WITH NEUROLOGICAL NEEDS 243

Prepare to administer other antiseizure drugs like Dilantin and phenobarbi-
tal. Propofol (Diprivan), a general anesthetic, can also be given to provide
continuous sedation if seizures continue.
Prevent complications like DVT, ventilaton-assisted pneumonia, and paralytic
ileus, which are common issues due to mechanical ventilation and sedation.

Guillain-Barré Syndrome (GBS)

What Went Wrong?
This syndrome is a rare but rapidly progressive paralytic disorder of the periph-
eral nervous system. It is believed to develop after a previous viral infection,
usually upper respiratory or gastrointestinal. It might be caused by an immune
response to infectious antigens that create a local inflammatory reaction that
triggers further inflammation.

Hallmark Signs and Symptoms
Motor weakness, especially in the lower extremities, has an abrupt onset that
progresses to flaccidity and ascends through the body over a period of hours to
days until the person’s mobility is absent and breathing, swallowing, speech, and Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
cough status is impaired to the point where approximately one-third of such
patients require intubation, mechanical ventilation, and a critical care environ-
ment. Pain in the hips, back, and thighs are common symptoms. The loss of
motor function can occur in as little as a few days up to 2 to 3 weeks.

Interpreting Test Results
Clinical diagnosis is based on actual symptoms, CSF analysis, and nerve conduc-
tion studies. Nerve conduction studies demonstrate a significant reduction of
nerve impulses. The CSF analysis will initially show a normal protein level that
elevates within the 4th to 6th week of illness.

Prognosis
This situation is reversible, but there is no curative treatment and the disease
must simply run its course. During its acute phase, the patient must be main-
tained in a critical care environment. Medical management focuses on the
prevention of complications and supporting bodily functions. The use of
steroids such as Decadron (dexamethasone) or Solu-Medrol (methylpredni-
solone) might be beneficial because of their anti-inflammatory effects.
Steroids also protect the neuromembrane from further destruction and