Guillain Barre Syndrome

August 14 20:54 2019 Print This Article

Guillain-Barre syndrome is a serious disorder that occurs when the body’s defense system mistakenly attacks part of the nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. GBS affects an estimated one to three in every 100,000 persons annually in the United States. It can strike any race at any age, but its incidence increases with age.

GBS may occur within days or weeks after a viral infection such as influenza (flu) or diarrhea. It may be triggered by pregnancy or a medical procedure, such as a vaccination or minor surgery, or have no evident reason for developing. Because the cause of GBS is unknown, there’s no way to prevent the disease from occurring. These symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the patient is almost totally paralyzed. In these cases the disorder is life threatening potentially interfering with breathing and, at times, with blood pressure or heart rate and is considered a medical emergency. Such a patient is often put on a respirator to assist with breathing and is watched closely for problems such as an abnormal heart beat, infections, blood clots, and high or low blood pressure. Most patients, however, recover from even the most severe cases of Guillain-Barré syndrome, although some continue to have a certain degree of weakness.

Guillain-Barre Syndrome is a disease of the nervous system due to damage to the myelin sheath around nerves. The myelin sheath is a fatty substance that surrounds nerve fibres, it increases the speed at which signals travel along the nerves. This syndrome can occur at any age but is most common between ages 30 and 50; it affects equally. Recovery is spontaneous and complete in about 95% of patients, although mild motor or reflex deficits in the feet and legs may persist. The prognosis is best when symptoms clear between 15 and 20 days after onset.

Guillain-Barre syndrome results in progressive muscle weakness or paralysis. It often follows an infectious chest or intestinal illness. Guillain-Barre Syndrome is the most frequent acquired nerve disease (neuropathy). In many cases it follows shortly after a virus infection. It is also rarely associated with immunizations, surgery, and childbirth.

Causes of Guillain Barre Syndrome

The exact cause of Guillain-Barre syndrome is unknown, but it may be a cellmediated immune response with an attack on peripheral nerves in response to a virus. The major pathologic effect is segmental demyelination of the peripheral nerves. Because this syndrome causes inflammation and degenerative changes in both the posterior (sensory) and the anterior (motor) nerve roots, signs of sensory and motor losses occur simultaneously. About 50% of patients with Guillain­Barre syndrome have a recent history of minor febrile illness, usually an upper respiratory tract infection or, less often, gastroenteritis. When infection precedes the onset of Guillain-Barre syndrome, signs of infection subside before neurologic features appear. Other possible precipitating factors include surgery, rabies or swine influenza vaccination, viral illness, Hodgkin’s disease, or some other malignant disease, and systemic lupus erythematosus.

Find common causes and risk factors of Guillain Barre Syndrome:

  • Respiratory infection.
  • Campylobacter food poisoning.

Signs and Symptoms of Guillain Barre Syndrome

Sign and symptoms may include the following:

  • Difficulty breathing.
  • Breathing problems.
  • Facial weakness.
  • Irritability.
  • Leg weakness or pain progressing to the arms.

Treatment for Guillain Barre Syndrome

The majority of patients can expect a slow but progressive recovery over several months. In severe cases the primary concern is maintaining vital functions and passively exercising the muscles. This sometimes requires temporary artificial breathing machines for severely affected patients. Plasmapheresis is a method to remove toxic substances from the blood and has been shown to improve outcome and shorten the disease. Intravenous immunoglobulin is also beneficial.

Treatment may include:

  • Primarily supportive, treatment consists of endotracheal intubation or tracheotomy if the patient has difficulty in clearing secretions.
  • A trial dose of prednisone may be given if the course of the disease is relentlessly progressive. If prednisone produces no noticeable improvement after 7 days, the drug is discontinued. Plasmapheresis is useful during thc initial phase but offers no benefit if begun 2 weeks after onset.