GUILLAIN BARRE SYNDROME
09:36 Jul 13 2011
Times Read: 2,373
Guillain–Barré syndrome
From Wikipedia, the free encyclopedia
Guillain-Barré syndrome
Classification and external resources
ICD-10 G61.0
ICD-9 357.0
OMIM 139393
DiseasesDB 5465
MedlinePlus 000684
eMedicine emerg/222 neuro/7 pmr/48 neuro/598
MeSH D020275
Guillain–Barré syndrome (GBS) (French pronunciation: [ɡiˈlɛ̃ baˈʁe], English pronunciation: /ˈɡiːlæn ˈbɑreɪ/), sometimes called Landry's paralysis, is an acute inflammatory demyelinating polyneuropathy (AIDP), a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom. It can cause life-threatening complications, particularly if the breathing muscles are affected or if there is dysfunction of the autonomic nervous system. The disease is usually triggered by an acute infection. Guillain–Barré syndrome is a form of peripheral neuropathy.
The diagnosis is usually made by nerve conduction studies. With prompt treatment by intravenous immunoglobulins or plasmapheresis, together with supportive care, the majority will recover completely. Guillain–Barré syndrome is rare, at 1–2 cases per 100,000 people annually, but is one of the leading causes of acute non-trauma-related paralysis in the world. The syndrome is named after the French physicians Georges Guillain and Jean Alexandre Barré, who described it in 1916.
Contents
[hide]
1 Classification
2 Signs and symptoms
3 Cause
3.1 Influenza
3.2 Influenza vaccine
4 Diagnosis
4.1 Diagnostic criteria
5 Management
6 Prognosis
7 Epidemiology
8 History
9 Notable cases
10 References
11 External links
Classification
Six different subtypes of Guillain–Barré syndrome exist:[citation needed]
Acute inflammatory demyelinating polyneuropathy (AIDP) is the most common form of GBS, and the term is often used synonymously with GBS. It is caused by an auto-immune response directed against Schwann cell membranes.
Miller Fisher syndrome (MFS) is a rare variant of GBS and manifests as a descending paralysis, proceeding in the reverse order of the more common form of GBS. It usually affects the eye muscles first and presents with the triad of ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are present in 90% of cases.
Acute motor axonal neuropathy (AMAN),[1] also known as Chinese paralytic syndrome, attacks motor nodes of Ranvier and is prevalent in China and Mexico. It is probably due to an auto-immune response directed against the axoplasm of peripheral nerves. The disease may be seasonal and recovery can be rapid. Anti-GD1a antibodies[2] are present. Anti-GD3 antibodies are found more frequently in AMAN.
Acute motor sensory axonal neuropathy (AMSAN) is similar to AMAN but also affects sensory nerves with severe axonal damage. Like AMAN, it is probably due to an auto-immune response directed against the axoplasm of peripheral nerves. Recovery is slow and often incomplete.[3]
Acute panautonomic neuropathy is the most rare variant of GBS, sometimes accompanied by encephalopathy. It is associated with a high mortality rate, owing to cardiovascular involvement, and associated dysrhythmias. Impaired sweating, lack of tear formation, photophobia, dryness of nasal and oral mucosa, itching and peeling of skin, nausea, dysphagia, constipation unrelieved by laxatives or alternating with diarrhea occur frequently in this patient group. Initial nonspecific symptoms of lethargy, fatigue, headache, and decreased initiative are followed by autonomic symptoms including orthostatic lightheadedness, blurring of vision, abdominal pain, diarrhea, dryness of eyes, and disturbed micturition. The most common symptoms at onset are related to orthostatic intolerance, as well as gastrointestinal and sudomotor dysfunction (Suarez et al. 1994). Parasympathetic impairment (abdominal pain, vomiting, obstipation, ileus, urinary retention, dilated unreactive pupils, loss of accommodation) may also be observed.
Bickerstaff's brainstem encephalitis (BBE), is a further variant of Guillain–Barré syndrome. It is characterized by acute onset of ophthalmoplegia, ataxia, disturbance of consciousness, hyperreflexia or Babinski's sign. The course of the disease can be monophasic or remitting-relapsing. Large, irregular hyperintense lesions located mainly in the brainstem, especially in the pons, midbrain and medulla are described in the literature. BBE despite severe initial presentation usually has a good prognosis. Magnetic resonance imaging (MRI) plays a critical role in the diagnosis of BBE. A considerable number of BBE patients have associated axonal Guillain–Barré syndrome, indicative that the two disorders are closely related and form a continuous spectrum.
Signs and symptoms
The disorder is characterized by symmetrical weakness which usually affects the lower limbs first, and rapidly progresses in an ascending fashion. Patients generally notice weakness in their legs, manifesting as "rubbery legs" or legs that tend to buckle, with or without dysesthesias (numbness or tingling). As the weakness progresses upward, usually over periods of hours to days, the arms and facial muscles also become affected. Frequently, the lower cranial nerves may be affected, leading to bulbar weakness, oropharyngeal dysphagia (drooling, or difficulty swallowing and/or maintaining an open airway) and respiratory difficulties. Most patients require hospitalization and about 30% require ventilatory assistance.[4] Facial weakness is also commonly a feature, but eye movement abnormalities are not commonly seen in ascending GBS, but are a prominent feature in the Miller-Fisher variant (see below.) Sensory loss, if present, usually takes the form of loss of proprioception (position sense) and areflexia (complete loss of deep tendon reflexes), an important feature of GBS. Loss of pain and temperature sensation is usually mild. In fact, pain is a common symptom in GBS, presenting as deep aching pain, usually in the weakened muscles, which patients compare to the pain from overexercising. These pains are self-limited and should be treated with standard analgesics. Bladder dysfunction may occur in severe cases but should be transient. If severe, spinal cord disorder should be suspected.
Fever should not be present, and if it is, another cause should be suspected.
In severe cases of GBS, loss of autonomic function is common, manifesting as wide fluctuations in blood pressure, orthostatic hypotension, and cardiac arrhythmias.
Acute paralysis in Guillain–Barré syndrome may be related to sodium channel blocking factor in the cerebrospinal fluid (CSF). Significant issues involving intravenous salt and water administration may occur unpredictably in this patient group, resulting in SIADH. SIADH is one of the causes of hyponatremia and can be accompanied with various conditions such as malignancies, infections and nervous system diseases. Symptoms of Guillain-Barré syndrome such as general weakness, decreased consciousness, and seizure are similar to those of hyponatremia
The symptoms of Guillain–Barré syndrome are also similar to those for progressive inflammatory neuropathy.[5]
Cause
Structure of a typical neuron Neuron
At one end of an elongated structure is a branching mass. At the centre of this mass is the nucleus and the branches are dendrites. A thick axon trails away from the mass, ending with further branching which are labeled as axon terminals. Along the axon are a number of protuberances labeled as myelin sheaths.
Dendrite
Soma
Axon
Nucleus
Node of
Ranvier
Axon terminal
Schwann cell
Myelin sheath
All forms of Guillain–Barré syndrome are due to an immune response to foreign antigens (such as infectious agents) that is mistargeted at host nerve tissues instead. The targets of such immune attack are thought to be gangliosides, compounds naturally present in large quantities in human nerve tissues. The most common antecedent infection is the bacterium Campylobacter jejuni.[6][7] However, 60% of cases do not have a known cause. One study suggests that a minority of cases may be triggered by the influenza virus, or by an immune reaction to the influenza virus.[8]
The end result of such autoimmune attack on the peripheral nerves is damage to the myelin, the fatty insulating layer of the nerve, and a nerve conduction block, leading to a muscle paralysis that may be accompanied by sensory or autonomic disturbances.
However, in mild cases, nerve axon (the long slender conducting portion of a nerve) function remains intact and recovery can be rapid if remyelination occurs. In severe cases, axonal damage occurs, and recovery depends on the regeneration of this important tissue. Recent studies on the disorder have demonstrated that approximately 80% of the patients have myelin loss, whereas, in the remaining 20%, the pathologic hallmark of the disorder is indeed axon loss.
Guillain-Barré, unlike disorders such as multiple sclerosis (MS) and Lou Gehrig's disease (ALS), is a peripheral nerve disorder and does not generally cause nerve damage to the brain or spinal cord.
Influenza
While influenza vaccines have sometimes been suspected to raise the incidence of GBS, the evidence is equivocal. On the other hand, getting infected by influenza itself increases both the risk of death (up to 1 in 10,000) and increases the risk of developing GBS to a much higher level than the highest level of suspected vaccine involvement (approx. 10 times higher by recent estimates).[9][10]
Influenza vaccine
GBS may be a rare side-effect of influenza vaccines; a study of the Vaccine Adverse Event Reporting System (VAERS) indicates that it is reported as an adverse event potentially associated with the vaccine at a rate of 1 per million vaccines (over the normal risk).[11] There were reports of GBS affecting 10 per million who had received swine flu immunizations in the 1976 U.S. outbreak of swine flu—25 of which resulted in death from severe pulmonary complications, leading the government to end that immunization campaign. (By comparison, the average flu season kills around 30,000 people in the United States).[12] However, the role of the vaccine even in those 25 cases in 1976 has remained unclear, partly because GBS had an unknown but very low incidence rate in the general population making it difficult to assess whether the vaccine was really increasing the risk for GBS. Later research has pointed to the absence of, or only a very small increase in, the GBS risk due to the 1976 swine flu vaccine.[13] Furthermore, the GBS may not have been directly due to the vaccine but to a bacterial contamination of the 1976 vaccine.[14]
Since 1976, no other influenza vaccines have been linked to GBS, though as a precautionary principle, caution is advised for certain individuals, particularly those with a history of GBS.[15][16]
From October 6 to November 24, 2009, the U.S. CDC, through the VAERS reporting system, received ten reports of Guillain-Barré syndrome cases associated with the H1N1 vaccine and identified two additional probable cases from VAERS reports (46.2 million doses were distributed within the U.S. during this time). Only four cases, however, meet the Brighton Collaboration case criteria for Guillain–Barré syndrome, while four do not meet the criteria and four remain under review.[17] A preliminary report by the CDC's Emerging Infections Programs (EIP) calculates the rate of GBS observed in patients who previously received the 2009 H1N1 influenza vaccination is an excess of 0.8 per million cases, which is on par with the rate seen with the seasonal trivalent influenza vaccine.[18]
Although one review gives an incidence of about one case per million vaccinations,[19] a large study in China, reported in the NEJM covering close to 100 million doses of vaccine against the 2009 H1N1 "swine" flu found only eleven cases of Guillain-Barré syndrome (0.1%) total incidence in persons vaccinated, actually lower than the normal rate of the disease in China, and no other notable side effects; "The risk-benefit ratio, which is what vaccines and everything in medicine is about, is overwhelmingly in favor of vaccination."[20]
Diagnosis
The diagnosis of GBS usually depends on findings such as rapid development of muscle paralysis, areflexia, absence of fever, and a likely inciting event. Cerebrospinal fluid analysis (through a lumbar spinal puncture) and electrodiagnostic tests of nerves and muscles (such as nerve conduction studies) are common tests ordered in the diagnosis of GBS.
cerebrospinal fluid
Typical CSF findings include albumino-cytological dissociation. As opposed to infectious causes, this is an elevated protein level (100–1000 mg/dL), without an accompanying increased cell count pleocytosis. A sustained increased white blood cell count may indicate an alternative diagnosis such as infection.
Electrodiagnostics
Electromyography (EMG) and nerve conduction study (NCS) may show prolonged distal latencies, conduction slowing, conduction block, and temporal dispersion of compound action potential in demyelinating cases. In primary axonal damage, the findings include reduced amplitude of the action potentials without conduction slowing.
Diagnostic criteria
Required:[citation needed]
Progressive, relatively symmetrical weakness of two or more limbs due to neuropathy
Areflexia
Disorder course < 4 weeks
Exclusion of other causes (see below)
Supportive:[citation needed]
relatively symmetric weakness accompanied by numbness and/or tingling
mild sensory involvement
facial nerve or other cranial nerve involvement
absence of fever
typical CSF findings obtained from lumbar puncture
electrophysiologic evidence of demyelination from electromyogram
Differential diagnosis:[citation needed]
acute myelopathies with chronic back pain and sphincter dysfunction
botulism with early loss of pupillary reactivity and descending paralysis
diphtheria with early oropharyngeal dysfunction
Lyme disease polyradiculitis and other tick-borne paralyses
porphyria with abdominal pain, seizures, psychosis
vasculitis neuropathy
poliomyelitis with fever and meningeal signs
CMV polyradiculitis in immunocompromised patients
critical illness neuropathy
myasthenia gravis
poisonings with organophosphate, poison hemlock, thallium, or arsenic
intoxication with Karwinskia humboldtiana leaves or seeds
paresis caused by West Nile virus
spinal astrocytoma
motor neurone disease
West Nile virus can cause severe, potentially fatal neurological illnesses, which include encephalitis, meningitis, Guillain-Barré syndrome, and anterior myelitis.
Management
Supportive care with monitoring of all vital functions is the cornerstone of successful management in the acute patient. Of greatest concern is respiratory failure due to paralysis of the diaphragm. Early intubation should be considered in any patient with a vital capacity (VC)
MY SON WHO IS TEN GOT THIS AT AGE 7 AND WAS VERY LUCKY TO SURVIVE AND WALK AGAIN. IN KIDS ITS NORMALLY FATAL. ITS IS SEEN MAINLY IN ADULTS. EVEN THOUGH SEAN IS NOW IN REMISSION HIS SPECIALIST SAYS IT COULD STRIKE ME AGAIN AND AT THE WORST THIS ILLNESS CAN LEAVE YOU DEAD OR PARALYZED.
ONLINE SAFETY AND PERSONAL SAFETY
05:32 Jul 02 2011
Times Read: 2,522
ONLINE SAFETY AND PERSONAL SAFETY.
NEVER GIVE YOUR PERSONAL DETAILS
LIKE YOUR HOME ADDRESS PHONE DETAILS ETC UNLESS IT'S A PREPAID CELL PHONE.
ALSO IF YOU KNOW ONE OF YOUR FRIENDS PLANS TO MEET SOMEONE ALONE FOR THE FIRST TIME, ESPECIALLY IF THEY ARE A MINOR AND UNDER 18, TELL THEIR PARENTS IF THEY WONT -DONT LET THEM FALL INTO THE HANDS OF A VICIOUS RAPIST THUG OR MURDERER. ITS BETTER THEY YELL AT YOU AND ARE ALIVE, THEN YOU SEEING THEM FOR THE LAST TIME DEAD IN A COFFIN OR BODY BAG.
WHEN OUT EATING WITH ANYONE YOU DONT KNOW WELL OR HAVE JUST MET FOR THE FIRST TIME, DONT LEAVE YOUR FOOD/DRINK UNATTENDED . IF YOU NEED TO GO TO THE BATHROOM, WHEN YOU COME BACK, ALWAYS ORDER A NEW DRINK OR FOOD SO THAT YOU DONT BECOME A VICTIM OF YOUR FOOD/DRINK BEING SPIKED, MANY PEOPLE HAVE DIED DUE TO THEIR FOOD AND DRINK BEING SPIKED. ALSO IF YOU SUDDENLY NOTICE YOUR FOOD /DRINK TASTES WEIRD STOP AND DONT EAT OR DRINK ANYMORE OF IT. IF YOU SUDDENLY BEGIN TO FEEL VERY UNWELL DIZZY ETC CHANCES ARE YOUR FOOD /DRINK MY HAVE BEEN SPIKED .. CALL 911 AND GET THE PARAMEDICS NOW!
NEVER MEET ANYONE YOU HAVE BEEN SPEAKING TO ONLINE ALONE AND NEVER INVITE THEM TO YOUR HOME UNTIL YOU KNOW THEM WELL.
ALWAYS KEEP A FULLY CHARGED CELL PHONE AND SOME MONEY WITH YOU AT ALL TIMES
IF THE PERSON APPEARS MENTALLY ILL DRUNK OR HIGH ON DRUGS OR AGRESSIVE OR YOU OBSERVE A WEAPON ON THEM THEN RUN!
IF ANY OF THEIR BEHAVIOUR MAKES YOU UNCOMFORTABLE LEAVE STRAIGHT AWAY AND CALL A FRIEND TO LET THEM KNOW
IF YOU CHANGE YOUR PLANS ON WHERE YOU WILL MEET OR WHAT YOU ARE DOING, THEN LET A FRIENDOR FAMILY MEMBER KNOW SO THEY KNOW WHERE TO START LOOKING FOR YOU SHOULD THEY NEED TO.
IF YOU CAN AND YOU HAVE LAW ENFORCEMENT FRIENDS GIVE THEM THE PERSON'S DETAILS THAT YOU ARE MEETING AND ASK THEM TO RUN A BACKGROUND CHECK ON THEM, AND IF THEY COME BACK WITH ANY VIOLENT OR ACUTE MENTAL HEALTH ISSUES CANCEL THE MEETING AND HAVE NOTHING TO DO WITH THEM
ALWAYS ASK FOR THEIR PERSONAL DETAILS -IE HOME ADDRESS PHONE NUMBER WORK DETAILS DATE OF BIRTH ETC IF POSSIBLE HAVE THEM VERIFIED BY A CONTACT IN LAW ENFORCEMENT. IF THEY WANT YOUR PERSONAL DETAILS BUT REFUSE TO GIVE YOU THEIRS, THEN RUN AWAY FAST!
ALWAYS MAKE YOUR PERSONAL BOUNDARIES CLEAR AND IF THE PERSON DOESNT RESPECT THEM THEN, GET OUT FAST AND NOW. WHILE YOU STILL CAN..
PERSONAL SAFETY
. IF YOU ARE UNDER18 OR EVEN OVER 18 TELL SOMEONE ,ESPECIALLY YOUR PARENTS IF SOMEONE WANTS TO MEET YOU. NEVER GO ALONE ONLY SEE THEM WITH AN ADULT IN A PUBLIC PLACE .I F YOU ARE OVER 18 TAKE AT LEAST TWO OTHER ADULT FRIENDS AS THERE IS SAFETY AND STRENGTH IN NUMBERS. EVEN AN ADULT CAN BE OVER POWERED AND ATTACKED. ALSO IF THEY SUGGEST /INSIST ON MEETING THEM IN SECRET ALONE RUN AWAY FAST!
ALSO IF YOU KNOW ONE OF YOUR FRIENDS PLANS TO MEET SOMEONE ALONE FOR THE FIRST TIME, ESPECIALLY IF THEY ARE A MINOR AND UNDER 18 TELL THEIR PARENTS IF THEY WONT -DONT LET THEM FALL INTO THE HANDS OF A VICIOUS RAPIST THUG OR MURDERER. ITS BETTER THEY YELL AT YOU AND ARE ALIVE, THEN YOU SEEING THEM FOR THE LAST TIME DEAD IN A COFFIN OR BODY BAG.
A TIP FROM TAE KWON DO: THE ELBOW IS THE STRONGEST POINT ON YOUR BODY. IF YOU ARE CLOSE ENOUGH TO USE IT DO SO..
2. IF A THUG DEMANDS YOUR WALLET /CELL PHONE/ETC DONT MAKE IT EASY AND HAND IT TO HIM THROW IT AS FAR AWAY FROM YOU AS POSSIBLE . CHANCES ARE THE THUG IS FAR MORE INTERESTED IN YOUR WALLET/CELL PHONE/ETC... RUN IN THE IN OTHER DIRECTION AND THEN GO FOR HELP.
3. IF YOU ARE EVER THROWN INTO THE TRUNK OF A CAR, KICK OUT THE BACK TAIL LIGHTS AND STICK YOUR ARM/FOOT OUT THE HOLE AND START WAVING LIKE CRAZY. THE DRIVER WONT SEE YOU BUT OTHERS WILL AND THIS HAS SAVED LIVES.
4.WOMEN HAVE A TENDENCY TO GET INTO THEIR CARS AFTER SHOPPING/WORKING /ETC, AND THEY SIT THERE DOING THEIR CHECKBOOK MAKING LIST'S READING MAIL ETC. DONT DO THIS AS YOU CAN GIVE A PREDATOR/THUG THE PERFECT CHANCE TO ATTACK YOU. AS SOON AS YOU GET INTO YOUR CAR LEAVE.IF SOMEONE GETS IN YOUR CAR DONT DRIVE OFF ,INSTEAD CRASH YOUR CAR INTO SOMETHING . YOUR AIR BAG SHOULD PROTECT YOU AND IF THE PERSON IS IN THE FRONT PASSENGER SEAT OR IN THE BACK THEY WILL BE CRITICALLY INJURED. AS SOON AS YOU THE CAR CRASHES JUMP OUT AND RUN!
5. A FEW NOTES ABOUT GETTING INTO YOUR CAR IN A PARKING LOT OR GARAGE.BE VERY AWARE AND LOOK AROUND YOU IN YOUR PASSENGER SIDE IN THE BACK SEAT AND THE FLOOR AND DONT KEEP ANYTHING LIKE A RUG IN YOUR CAR THAT SOMEONE COULD USE TO HIDE UNDER IN YOUR CAR AND KEEP YOUR CAR ALWAYS LOCKED,EVEN WHEN YOUR DRIVING.
IF YOU ARE PARKED NEXT TO A HUGE VAN,ENTER FROM THE PASSENGER SIDE ONLY AS MOST THUGS/PREDATORS ATTACK THEIR VICTIMS BY PULLING THEM INTO THEIR VANS WHILE THE PERSON WAS ATTEMPTING TO GET IN TO THEIR CARS.
ALSO LOOK AT THE CARS THAT ARE PARKED ON BOTH SIDES OF YOUR VEHICLE AND IF A MALE IS SITTING IN THEM ALONE GO GET A SECURITY GUARD OR A POLICEMAN TO WALK YOU BACK TO YOUR CAR ESPECIALLY AT NIGHT. DONT TAKE CHANCES WITH YOUR SAFETY, BE WISE AND PLAY IT SAFE..
WHEN OUT EATING WITH ANYONE YOU DONT KNOW WELL OR HAVE JUST MET FOR THE FIRST TIME DONT LEAVE YOUR FOOD/DRINK UNATTENDED . IF YOU NEED TO GO TO THE BATHROOM WHEN YOU COMEBACK ORDER A NEW DRINK OR FOOD SO THAT YOU DONT BECOME A VICTIM OF YOUR FOOD/DRINK BEING SPIKED, MANY PEOPLE HAVE DIED DUE TO THEIR FOOD AND DRINK BEING SPIKED, ALSO IF YOU SUDDENLY NOTICE YOUR FOOD /DRINK TASTES WEIRD STOP AND DONT LET ANYMORE OR IT. IF YOU SUDDENLY BEGIN TO FEEL VERY UNWELL DIZZY ETC CHANCES ARE YOUR FOOD /DRINK MY HAVE BEEN SPIKED .. CALL 911 AND GET THE PARAMEDICS NOW!
ARRIVE AND LEAVE SEPARATELY DONT ALLOW THEM TO GIVE YOU A LIFT .
DONT DRINK ALCOHOL OR TAKE ANY DRUGS AND STAY SOBER SO THAT YOU STAY SAFE.
IF THEIR BEHAVIOUR MAKES YOU FEEL AFRAID RUN AWAY FAST!
IF THE PERSON APPEARS MENTALLY ILL DRUNK OR HIGH ON DRUGS OR YOU OBSERVE A WEAPON ON THEM THEN RUN AWAY FAST!
IF YOU CHANGE YOUR PLANS ON WHERE YOU WILL MEET OR WHAT YOU ARE DOING, THEN LET A FRIEND FAMILY MEMBER KNOW SO THEY KNOW WHERE TO START LOOKING FOR YOU SHOULD THEY NEED TO
IF MEETING THEM FOR THE FIRST TIME ARRANGE TO HAVE SOME OTHER FRIENDS WITH YOU THERE IS SAFETY IN NUMBERS ND MOST THUGS WHO ATTACK SOMEONE DONT WANT WITNESSES AROUND FOR OBVIOUS REASONS.
IF YOU CAN AND YOU HAVE LAW ENFORCEMENT FRIENDS GIVE THEM THE PERSON'S DETAILS THAT YOU ARE MEETING AND ASK THEM TO RUN A BACKGROUND CHECK ON THEM AND IF THEY COME BACK WITH ANY VIOLENT OR ACUTE MENTAL HEALTH ISSUES CANCEL THE MEETING AND HAVE NOTHING TO DO WITH THEM.
ALWAYS ASK FOR THEIR PERSONAL DETAILS -IE HOME ADDRESS PHONE NUMBER WORK DETAILS DATE OF BIRTH ETC IF POSSIBLE HAVE THEM VERIFIED BY A CONTACT IN LAW ENFORCEMENT. IF THEY WANT YOUR PERSONAL DETAILS BUT REFUSE TO GIVE YOU THEIRS, THEN RUN AWAY FAST!
ALWAYS ALWAYS TRUST YOUR INTUITION IF YOU FEEL UNEASY TRUST YOURSELF AND DONT MEET UP WITH THEM. IF IN DOUBT THEN DONT!
ALWAYS MAKE YOUR PERSONAL BOUNDARIES CLEAR AND IF THE PERSON DOESNT RESPECT THEM THEN GET OUT FAST AND NOW.
WHILE YOU STILL CAN..
PLEASE LISTEN TO WHAT I HAVE SAID HERE CAREFULLY AS I DONT WANT TO BE READING ABOUT YOUR RAPE OR MURDER OR VIOLENT ASSAULT IN THE NEWSPAPER OR HEAR ABOUT IT ON THE NIGHTLY NEWS.
ALSO IF YOU KNOW ONE OF YOUR FRIENDS PLANS TO MEET SOMEONE ALONE FOR THE FIRST TIME, ESPECIALLY IF THEY ARE A MINOR AND UNDER 18 TELL THEIR PARENTS IF THEY WONT -DONT LET THEM FALL INTO THE HANDS OF A VICIOUS RAPIST THUG OR MURDERER. ITS BETTER THEY YELL AT YOU AND ARE ALIVE, THEN YOU SEEING THEM FOR THE LAST TIME DEAD IN A COFFIN OR BODY BAG.
ALSO IF YOU ARE UNFORTUNATE ENOUGH TO BE ATTACKED RAPED OR HARMED GO GET HELP AND CHARGE THEM! THAT WAY YOU LESSEN THE CHANCE THAT THEY CAN DO THIS TO SOME ONE ELSE AND YOU CAN THEN START THE HEALING PROCESS. NO MAN WOMAN OR CHILD EVER DESERVES TO BE HARMED EVER..
ONLINE SAFETY IN CHAT ROOMS FOR KIDS AND ADULTS
NEVER GIVE OT YOUR PERSONAL DETAILS OR YOUR REAL NAME UNLESS YOU REALLY KNOW THE PERSON WELL.
PERSONALLY I FEEL KIDS SHOULD ONLY BE ALLOWED IN CHAT ROOMS ONCE THEY ARE 15 YEARS OF AGE AND ONLY IF THEY HAVE A COMPETENT ADULT SUPERVISING THEM WHO HAS ALL THEIR PROFILE/ EMAIL/ WEBSITE/ PASSWORDS.
IF YOU HAVE CHILDREN WHO ARE ONLINE MAKE SUE THAT YOU HAVE ALL THEIR ONLINE SCREEN LOG IN DETAILS PASSWORD REGUALAR WEBSITES THEY VISIT AND CHECK THEIR EMAIL WEB PAGES PROFILES REGUARLY WITHOUT WARNING AND IF THY HAVE BROKEN YOUR SAFETY RULES OR THEY ARE RECIEVING INAPPROPRIATE MAIL ETC THEN SUSPEND THEIR USE STRAIGHT AWAY.
KEEP ALL FAMILY COMPUTERS USED BY CHILDREN AND TEENAGERS IN A SHARED AREA OF YOUR HOME, SO THAT YOU CAN MONITOR WHAT YOUR CHILDREN ARE DOING ONLINE.
TEACH YOUR KIDS TO COME TO YOU WITH ALL THEIR ISSUED BY BEING KIND LOVING AND MOST IMPORTANT UN JUDGMENTAL. THAT WAY IF THEY ARE HAVING PROBLEMS WITH CYBERBULLYING ETC THEY WILL COME TO YOU .
TEACH AND ROLE MODEL APPROPRIATE BEHAVIOUR SO THAT YOUR CHILDREN TEENAGERS AND FAMILY MEMBERS DONT BECOME CYBER BULLIES. IF YOU CATCH THEM BULLYING REMOVE THEIR INTERNET ACCESS AS NOT ONLY IS CYBER BULLYING IMMORAL IT IS ALSO ILLEGAL.
NEVER SEND PHOTOS OF YOURSELF TO ANYONE THAT ARE NUDE ETC AS YOU NEVER KNOW WHEN THEY COULD BE USED AGAINST YOU AND PUT UP ON THE INTERNET SOMEWHERE, CAUSING YOU TO LOSE YOUR JOB FRIENDS GREAT EMBARESSMENT OR EVEN TO LOSE YOUR LIFE.
NEVER NEVER EVER GIVE YOUR PASSWORDS FOR ANY OF YOUR ACCOUNTS TO ANYONE EXCEPT YOUR PARENTS AS THEY COULD DELETE YOUR ACCOUNT SEND NASTY MESSAGES CYBER BULLY AND AS YOU AER RHE ACCOUNT HOLDER IT IS YOU THAT CAN BE CHARGED AND WHO WILL GET THE BLAME AS IT IS YOUR ACCOUNT. IGNORANCE IS NO EXCUSE INTHE EYES OF THE LAW!
TRY NOT TO DO INTERNET BANKING OR FINANCIAL TRANSACTIONS ONLINE, AS YOU CAN BE HACKED INTO AND LOSE ALL YOUR MONEY.
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