Climbing Gary — Guillain-Barré Syndrome
Ascending weakness after a GI infection — watch vital capacity, not just strength
Gary recovered from a stomach bug two weeks ago, but now his feet feel numb and heavy climbing the stairs. By evening, he can't lift his legs off the bed at all.
Two weeks after a bout of diarrhea, Gary's immune system attacks his peripheral nerves. Weakness starts in his feet and climbs upward, symmetric and progressive. The real danger is not the limb weakness itself but how high it climbs — when it reaches the diaphragm and intercostal muscles, respiratory failure follows, so vital capacity is monitored far more closely than muscle strength grades.
Read Climbing Gary's full story →The story arc
The setup
Gary had a Campylobacter gastrointestinal infection two weeks earlier and thought he was fully recovered.
The turn
Numbness and tingling start in his toes and fingers, and within a day his legs feel too weak to climb the stairs.
The crisis
By that evening Gary cannot lift his legs at all, his voice sounds breathless mid-sentence, and his vital capacity has dropped from 3800 mL to 1500 mL.
The save
The nurse trends his vital capacity and negative inspiratory force every 2–4 hours, keeps intubation equipment ready, and the team starts IV immunoglobulin or plasmapheresis while providing meticulous DVT and skin care during his paralysis.
NCLEX study section — Guillain-Barré Syndrome
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Neurological
Take this chapter into practice questions on the same topic.