GUILLAIN BARRE SYNDROME

Guillain-Barre syndrome is a rare disorder that causes your immune system to attack your peripheral nervous system (PNS). The PNS nerves connect your brain and spinal cord with the rest of your body. Damage to these nerves makes it hard for them to transmit signals. As a result, your muscles have trouble responding to your brain. 

Causes

The cause of the disease is unknown. Many speculate that this is an immune-system disorder. Symptoms often begin 5 days to 3 weeks after a viral infection, immunization, orsurgery.

The disease affects peripheral nerves, nerve roots, and cranial nerves. Evaluation of the peripheral nerves reveals sections of the nerve with demyelination. Under microscopic exam, the nerve tissue is infiltrated with certain types of white blood cells.

• A viral infection, such as herpes,cytomegalovirus, or Epstein-Barr virus is the cause of over two-thirds of the new cases each year.
• In 1977, there were over 500 cases of Guillain-Barre syndrome associated with a United States flu vaccination program. The cause of this outbreak was never discovered.
• 5-10% of new cases will occur up to 4 weeks after surgery.

Symptoms

Guillain-Barre syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. These symptoms may begin — often not causing much notice — in your fingers and toes. In some people, symptoms begin in the arms or even the face. As the disorder progresses, muscle weakness can evolve into paralysis.

Signs and symptoms of Guillain-Barre syndrome may include:

• Prickling, "pins and needles" sensations in your fingers, toes or both
• Weakness or tingling sensations in your legs that spread to your upper body
• Unsteady walking or inability to walk
• Difficulty with eye movement, facial movement, speaking, chewing or swallowing
• Severe pain in your lower back
• Difficulty with bladder control or intestinal functions
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing

Most people with Guillain-Barre syndrome experience their most significant weakness within four weeks after symptoms begin. In some cases, signs and symptoms may progress very rapidly, with complete paralysis of legs, arms and breathing muscles over the course of a few hours.

Seek emergency medical help if you have any of the following severe signs or symptoms:

• Tingling that started in your feet or toes and is now ascending through your body
• Tingling or weakness that's spreading rapidly
• Tingling that involves both your hands and feet
• Difficulty catching your breath
• Choking on saliva

Guillain-Barre syndrome is a serious disease that requires immediate hospitalization because of the rapid rate at which it worsens. The sooner appropriate treatment is started, the better the chance of a good outcome.

Diagnosis

Your doctor will ask when your symptoms started and how they have changed. He or she also may ask if you've had any recent infections.

Two signs are important in helping your doctor decide if you have GBS:

• Your arms and legs are getting weaker.
• You are losing your reflexes, which are automatic body movements that you can't control.

Your doctor also may do tests, such as a lumbar puncture and a nerve conduction study.

If the diagnosis isn't clear, you may be referred to a doctor who specializes in the nervous system (neurologist).

Treatment

The progress of the disorder is very difficult to predict. Most people diagnosed with Guillain-Barrè syndrome are hospitalised so that any complications which affect their vital functions can be treated promptly. There is no cure, but treatment options include:

• Plasmapheresis - blood is taken from the patient. The immune cells are removed, and the remaining red blood cells are returned to the body.
• Gammaglobulin (IVIG) - trials have proven the effectiveness of this form of treatment. IVIG is given by infusion into a vein, usually every day for five days. Each infusion takes about two hours.

Possible Complications

• Breathing difficulty (respiratory failure)
• Contractures of joints or other deformity
• Deep vein thrombosis (blood clots that form when someone is inactive or confined to bed)
• Increased risk of infections
• Low or unstable blood pressure
• Paralysis that is permanent
• Pneumonia
• Skin damage (ulcers)
• Sucking food or fluids into the lungs (aspiration)
  
  
  
  Please Note
  
  

  

  
  

Seek immediate medical help if you have any of the following symptoms:

• Can't take a deep breath
• Decreased feeling (sensation)
  • Difficulty breathing
  • Difficulty swallowing
  • Fainting
  • Loss of movement

There is currently no known prevention for GBS. However, the best way to stay healthy is to make regular physical activity a part of your daily routine and to eat a well-balanced, healthy diet.