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Hypertension and Bradycardia in Severe Guillain-Barré Syndrome 

Hypertension and Bradycardia in Severe Guillain-Barré Syndrome
Chapter:
Hypertension and Bradycardia in Severe Guillain-Barré Syndrome
Source:
Neurocritical Care (2 ed.)
Author(s):

Eelco F. M. Wijdicks

, Alejandro A. Rabinstein

, Sara E. Hocker

, and Jennifer E. Fugate

DOI:
10.1093/med/9780190602659.003.0032

Dysautonomia is common in severe forms of Guillain-Barré syndrome. Paralytic ileus is a concern in all immobilized bedridden patients with this syndrome. Marked blood pressure fluctuations or sustained hypertension are the most concerning manifestations. Treatment of these autonomic disorders is provided in this chapter. Hypertensive surges can be treated with morphine, clonidine, or, if necessary, an infusion of a calcium channel blocker, such as nicardipine. Vagal spells may lead to prolonged episodes of asystole, and a transcutaneous pacemaker might be needed. Every bedridden patient with severe Guillain-Barré syndrome is at risk of developing severe adynamic ileus, and treatment may require a period of parenteral nutrition or colonoscopic decompression.

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