Guillain-Barre syndrome (GBS)

2021-08-04 04:30 PM

The exact cause of Guillain-Barre syndrome is unknown but is often preceded by an infectious disease such as a respiratory or stomach infection.

Define

Guillain-Barre syndrome is a rare disorder in which the body's immune system attacks the nerves. The first symptom is usually weakness and numbness in the extremities. These sensations can quickly spread, eventually paralyzing the entire body.

The exact cause of Guillain-Barre syndrome is unknown but is often preceded by an infectious disease such as a respiratory or stomach infection. Fortunately, Guillain-Barre syndrome is relatively rare, affecting only 1 or 2 people per 100,000 people.

The most severe form of Guillain-Barre syndrome is a medical emergency that requires hospitalization. There is no specific cure for Guillain-Barre syndrome, but several methods can ease symptoms and reduce the duration of the disease. And most people make a full recovery.

Symptoms

Guillain-Barre syndrome usually begins with weakness, itching, or loss of sensation that begins in the legs and feet and spreads to the trunk and arms. These symptoms can start in the fingers and toes that usually go unnoticed. In some people, symptoms start in the arms or even the face. As the disorder progresses, weak muscles can develop into paralysis.

Signs and symptoms of Guillain-Barre syndrome may include

Itching or loss of sensation in the fingers, toes, or both.

Weakness or itching sensation in the legs spreading to the upper body.

Unsteady walking or inability to walk.

Difficulty with eye movements, facial movements, speaking, chewing, swallowing.

Severe pain in the lower back.

Difficulty controlling bladder or bowel functions.

Very slow heart rate or low blood pressure.

Shortness of breath.

Most people with Guillain-Barre syndrome experience the most significant weakness within three weeks of the onset of symptoms. In some cases, signs and symptoms can progress very rapidly with complete paralysis of the legs, arms, and respiratory muscles over the course of several hours.

Call your doctor if mild itching in your toes or fingers seems to spread or gets worse.

Seek medical attention if any of the following serious signs or symptoms are present

Itching starts in the legs or toes and increases gradually up the body.

Itching or weakness spreads quickly.

Itching involves both hands and feet.

Shortness of breath.

Choking saliva.

Guillain-Barre syndrome is a serious illness that requires immediate hospitalization because of its rapidly worsening rate. Appropriate treatment is better started earlier, giving a better chance of a good outcome.

Guillain-Barre syndrome

Causes

The exact cause of Guillain-Barre syndrome is unknown. In about 60 percent of cases, the infection affects both -- the lungs or the gastrointestinal tract precedes these disorders. But scientists don't know why that can lead to Guillain-Barre syndrome in some people and not in others. Many cases of the disease appear without any predisposing factors.

In Guillain-Barre syndrome, the immune system normally attacks only foreign objects and invading organisms, starting to attack the nerves that transmit signals between the body and the brain. Specifically, the protective covering of the nerve (myelin sheath) is damaged and this interferes with signal transmission, causing weakness, numbness, or paralysis.

Risk factors

Guillain-Barre syndrome can affect all age groups, but there is a greater risk if

Youth age.

Senior age.

Guillain - Barre can be activated by

The most common, infection with campylobacter, a bacteria commonly found in undercooked food, especially poultry.

Surgery.

Epstein-Barr virus.

Hodgkin's disease.

Mononucleosis.

HIV, the virus that causes AIDS.

Rarely, rabies or flu vaccination.

Complications

Complications of Guillan-Barre syndrome can include:

Shortness of breath

A potentially fatal complication of Guillain-Barre syndrome is weakness or paralysis that can spread to the muscles that control breathing. You may need temporary help with a ventilator when you're hospitalized for treatment.

Numbness or other sensations

Most people with Guillain-Barre syndrome make a full recovery or have only minor sensory impairment or abnormalities, such as numbness or tingling. However, full recovery can be slow, often a year or so.

Less than 1 in 10 people with Guillain-Barre syndrome experience long-term complications, such as:

Serious long-term problems with sensation and coordination, including in some cases severe disability.

Guillain-Barre syndrome recurrence.

Rarely, fatal complications such as respiratory distress syndrome and heart attack.

Severe early symptoms of Guillain-Barre syndrome significantly increase the risk of serious long-term complications.

Testing and diagnosis

Guillain-Barre syndrome can be difficult to diagnose in its earliest stages. Its signs and symptoms are similar to other neurological disorders and can vary from person to person.

The first step in diagnosing Guillain-Barre syndrome is to ask for a careful medical history to learn the signs and symptoms you're experiencing.

Lumbar puncture and neurological function tests are often used to help confirm the diagnosis of Guillain-Barre syndrome.

Lumbar puncture. This procedure involves collecting small amounts of fluid from the spinal canal. The cerebrospinal fluid is then tested.

Nerve function test. Your doctor may want information from two types of nerve function tests - electromyography and nerve conduction velocity:

Electromyography records electrical activity in muscles to identify weakness due to muscle damage or nerve damage.

Nerve conduction studies evaluate how nerves and muscles respond to electrical stimuli.

Treatments and drugs

Although it can take some people months and even years to recover, most cases of Guillain-Barre syndrome go through stages:

After the first symptom, the condition tends to gradually worsen over about two weeks.

Symptoms reach a plateau and remain stable for 2 - 4 weeks.

Recovery begins, which usually lasts six to 12 months.

There is no specific cure for Guillain-Barre syndrome. But two treatments speed recovery and reduce the severity of Guillain-Barre syndrome:

Treatment with purified plasma (Plasmapheresis). This treatment is also known as plasma exchange in which damaging antibodies in the blood are removed. Treatment with purified plasma involves removing the liquid part of the blood (plasma) and separating it from the actual blood cells. These cells are then put back into the body. It's not clear why this treatment is used, but scientists believe that removing the antibodies contributes to the immune system's attack on peripheral nerves.

Immunoglobulins (Immunoglobulins). Contains healthy immunoglobulin antibodies from blood donors. High-dose immunoglobulins can block damaging antibodies that can contribute to Guillain-Barre syndrome.

Each treatment method is equally effective. Combination of treatments when treatment with one is ineffective.

Often before recovery begins, it may be necessary to move the arms and legs on their own to keep the muscles flexible and strong. Once recovery has begun, physical therapy will be needed to help regain strength and proper movement. Training with adaptive devices, such as a wheelchair or braces, may be needed for mobility and self-care skills.

Coping and supporting

The emotional impact of Guillain-Barre syndrome can be dire. In severe cases, Guillain-Barre syndrome can turn from healthy and independent to sudden severe illness and physical impotence without warning.

Although most people eventually make a full recovery, a diagnosis of Guillain-Barre syndrome means facing the possibility of long-term disability or paralysis. And those who develop complications must adjust to mobility, and dependence on others to help manage daily activities.

Talking with a mental health provider can play an important role in helping to cope with the mental and emotional stress of this illness. In some cases, a therapist may recommend counseling for families and loved ones to adjust to the changes caused by Guillain-Barre syndrome.

It is also possible to benefit from talking to people who have had this experience. Ask your doctor or mental health provider to recommend a support group for dealing with Guillain-Barre syndrome.