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Guillain-Barre Syndrome

Definition


Disease: Guillain-Barre Syndrome Guillain-Barre Syndrome
Category: Neurological diseases
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Disease Definition:

In Guillain-Barre syndrome the body's immune system attacks the nerves. This is an uncommon disorder, the first symptoms of which is weakness and numbness in the extremities. These are sensations that could spread quickly and end up paralyzing the whole body.

 

In most cases, Guillain-Barre syndrome follows an infectious illness, including the stomach flu and a respiratory infection. However, the exact cause of this syndrome is still not known. Affecting only 1 to 2 people in every 100,000 this syndrome is quite rare.

 

Guillain-Barre syndrome is a medical emergency that requires hospitalization in its most severe form. Although several treatments are available that could ease the symptoms and reduce the duration of the illness and most people recover completely, however, there's no known cure for Guillain-Barre syndrome.
 

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Usually, weakness, tingling or loss of sensation that starts in the feet and legs and spreads to the upper body and arms is how Guillain-Barre syndrome begins. Symptoms may begin in your toes and fingers and they usually don't cause much notice. Symptoms could also begin in the arms or even the face in some people. Muscle weakness could evolve into paralysis as the disorder progresses. Listed below are some of the signs and symptoms of Guillain-Barre syndrome:

 

  • Inability to walk, or unsteady walking
  • Low blood pressure or very slow heart rate
  • Difficulty breathing
  • Weakness or tingling sensations in the legs which usually spread to the upper body
  • Severe pain in the lower back
  • Prickling, "pins and needles" sensations in both fingers and toes or in either one of them.
  • Difficulty with intestinal functions or with bladder control
  • Difficulty with eye movement, speaking, swallowing, chewing or facial movement.

 

Within three weeks after the symptoms begin, most people with Guillain-Barre syndrome experience their most significant weakness. Sometimes, in the course of a few hours, the signs and symptoms could progress very rapidly with total paralysis of arms, legs and breathing muscles.

 

In case someone has mild tingling in their toes or fingers that doesn't seem to be spreading or getting worse, they should call a doctor. However, if someone experiences any of these severe signs and symptoms, they should seek immediate emergency medical help:

 

  • Chocking on saliva
  • Difficulty catching their breath
  • Tingling that starts in the feet or toes and then ascends upward through the body.
  • Tingling that involves both the hands and feet
  • Weakness or tingling that spreads rapidly

 

Because of the rapid rate at which Guillain-Barre syndrome worsens, it is considered a serious disease that requires immediate hospitalization. A person's chances of a good outcome will be better if they start appropriate treatment soon.
 

Causes:

About 60% of the cases of Guillain-Barre syndrome are preceded with an infection that affects either the lungs or the digestive tract. However, the exact cause of Guillain-Barre syndrome is still not known and scientists still haven't discovered why these infections lead to Guillain-Barre syndrome in some people and not in others. There are many cases that seem to occur without any triggers.

 

Usually, the immune system only attacks foreign material and invading organisms, however, in Guillain-Barre syndrome, it starts attacking the nerves that carry signals between the body and the brain. Because the nerves' protective covering called myelin sheath is damaged, the signaling process is interfered causing numbness, paralysis or weakness.
 

Complications

Complications:

Some of the complications that Guillain-Barre syndrome may cause include:

 

Breathing difficulties:

The weakness or paralysis could spread to the muscles that control breathing, which is a potentially deadly complication of Guillain-Barre syndrome. When the patient is hospitalized for treatment, they may need temporary help from a machine to breathe.

 

Residual numbness or other sensations:

Even though full recovery may be slow, usually taking a year or longer, however, most people with Guillain-Barre syndrome recover completely. Some people may have only minor, residual weakness or abnormal sensations such as tingling or numbness.

 

These are some of the long-term complications that less than 1 in 10 people with Guillain-Barre syndrome may experience:

 

  • A relapse of Guillain-Barre syndrome
  • Serious and permanent problems with sensations and coordination, including some cases of severe disability
  • In some rare cases, complications such as heart attack and respiratory distress syndrome could lead to death

 

Someone's risks of serious long-term complications are increased by severe, early symptoms of Guillain-Barre syndrome.
 

Treatments:

This is the general timeline of recovery from Guillain-Barre syndrome:

 

  • The condition tends to progressively worsen for about two weeks after the initial symptoms
  • For two to four weeks after that, symptoms reach a plateau and remain steady
  • Recovery begins and lasts 6 months to a year

 

Some people could take months and even years to recover. This syndrome has no cure. However, there are two types of treatments that reduce the severity of Guillain-Barre syndrome and speed recovery, these are:

 

Intravenous immunoglobulin:

High doses of immunoglobulin could block the damaging antibodies that may contribute to Guillain-Barre syndrome, because it contains healthy antibodies from blood donors.

 

Plasmapheresis:

In this treatment damaging antibodies are removed from the blood. Also called plasma exchange, this treatment is a type of "blood cleansing". In this treatment the liquid portion of the blood (plasma) will be removed and separated from the actual blood cells. Then, the blood cells are put back into the body where they manufacture more plasma in order to make up for what was removed. Although it's not entirely clear why this treatment works, however, scientists think that it rids plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.

 

Both of these methods are equally effective. Administering one treatment after the other or mixing them together is no more effective than using each one alone.

 

Before recovery begins, in order to keep the muscles flexible and strong, caregivers may need to manually move the patient's arms and legs. After recovery begins, in order to regain strength and proper movement, the patient will probably need physical therapy so that they'll be able to function on their own. The patient will likely be trained with adaptive devices that give mobility and self-care skills, including braces or a wheelchair.
 

Prognosis:

Not available

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