What is Guillain-Barre Syndrome?

Guillain-Barre Syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment. The exact cause of Guillain-Barre syndrome is unknown. But it is often preceded by an infectious illness such as a respiratory infection or the stomach flu.

There's no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people recover from Guillain-Barre syndrome, though some may experience lingering effects from it, such as weakness, numbness or fatigue.

 

Risk Factors

Guillain-Barre syndrome can affect all age groups. But you're at slightly greater risk if:

  • You're a man
     
  • You're a young adult
     

Guillain-Barre syndrome may be triggered by:

  • Most commonly, infection with campylobacter, a type of bacteria often found in undercooked poultry
     
  • Influenza virus
     
  • Cytomegalovirus
     
  • Epstein-Barr virus
     
  • Zika virus
     
  • Hepatitis A, B, C and E
     
  • HIV, the virus that causes AIDS
     
  • Mycoplasma pneumonia
     
  • Hodgkin's lymphoma
     
  • Rarely, influenza vaccinations or childhood vaccinations

 

Diagnosis

The initial signs and symptoms of GBS are varied and there are several disorders with similar symptoms.  Therefore, doctors may find it difficult to diagnose GBS in its earliest stages.

Physicians will note whether the symptoms appear on both sides of the body (the typical finding in Guillain-Barré syndrome) and the speed with which the symptoms appear (in other disorders, muscle weakness may progress over months rather than days or weeks). In GBS, deep tendon reflexes in the legs, such as knee jerks, are usually lost. Reflexes may also be absent in the arms. Because the signals traveling along the nerve are slow, a nerve conduction velocity test (NCV, which measures the nerve’s ability to send a signal) can provide clues to aid the diagnosis. There is a change in the cerebrospinal fluid that bathes the spinal cord and brain in people with GBS. Researchers have found the fluid contains more protein than usual but very few immune cells (measured by white blood cells). Therefore, a physician may decide to perform a spinal tap or lumbar puncture to obtain a sample of spinal fluid to analyze. In this procedure, a needle is inserted into the person’s lower back and a small amount of cerebrospinal fluid is withdrawn from the spinal cord. This procedure is usually safe, with rare complications.


Key diagnostic findings include:

  • Recent onset, within days to at most four weeks of symmetric weakness, usually starting in the legs
     
  • Abnormal sensations such as pain, numbness, and tingling in the feet that accompany or even occur before weakness
     
  • Absent or diminished deep tendon reflexes in weak limbs
     
  • Elevated cerebrospinal fluid protein without elevated cell count.This may take up to 10 days from onset of symptoms to develop.
     
  • Abnormal nerve conduction velocity findings, such as slow signal conduction
     
  • Sometimes, a recent viral infection or diarrhea.

 

Treatment

There is currently no cure for GBS, but medications are available to ease symptoms.

There are two types of treatment that can reduce the severity of symptoms and improve the rate of recovery:

  • Immunoglobulin therapy: Antibodies from donors are given intravenously (IV). This treatment seems to reduce the autoimmune response that occurs.
     
  • Plasma exchange, also known as plasmapheresis: Blood is taken from the body. The blood plasma is then separated from the blood cells. The blood cells are returned, and the body regenerates plasma. This process removes some of the antibodies attacking healthy cells.
     
  • Both methods are similarly effective. However, using them together does not improve outcomes. Researchers do not yet know exactly why either method works.

 

 

# GUILLAIN-BARRE SYNDROME BY THE NUMBERS #

 

  • One in 20 cases of GBS is fatal. However, the majority of patients make a full recovery.

  • About 80 percent can walk independently six months after diagnosis

  • About 60 percent fully recover motor strength one year after diagnosis

 

 

 

 

 

 

 


Sources:

  • “Guillain-Barre Syndrome.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 18 May 2018, www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793.

  • “Guillain-Barre Syndrome: What It Is and How It's Treated.” WebMD, WebMD, www.webmd.com/brain/what-is-guillain-barre#1.

  • “Guillain-Barré Syndrome Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Guillain-Barre-Syndrome-Fact-Sheet.

  • “Guillain-Barré Syndrome.” NORD (National Organization for Rare Disorders), rarediseases.org/rare-diseases/guillain-barre-syndrome/. 

  • Newman, Tim. “Guillain-Barré Syndrome: Symptoms, Causes, Diagnosis, and Treatment.” Medical News Today, MediLexicon International, 19 Dec. 2017, www.medicalnewstoday.com/articles/167892.php.

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