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Guillain-Barré Syndrome is a rare condition of the nervous system in which the myelin sheath covering the nerves are damaged. It causes muscle weakness and paralysis, numbness or tingling sensation in the limbs, face and other parts of the body. In severe cases, it can even cause death when the muscles of the respiratory system are affected.
The cause of Guillain-Barré Syndrome is not quite known for certain, but it is believed to be an autoimmune condition, in which the body's immune system attacks it's own cells.
Symptoms
Guillain-Barré Syndrome is characterized by symmetrical weakness of the limbs. The lower limbs are typically affected first, and this weakness rapidly progresses upwards. Early symptoms are often that of tingling, numbness or weakness in the lower limbs. As the weakness progresses upwards, the upper limbs and facial muscles also become affected. As the condition progresses, weakness may become full blown paralysis.
As the lower cranial nerves and respiratory muscles become affected, there may be drooling, difficulty swallowing, difficulty maintaining an open airway and respiratory difficulties. Some patients may require ventilatory support.
Pain is also a common symptom, presenting as a deep aching, muscular pain. There may be difficulty with bladder and bowel control, wide fluctuations in blood pressure, orthostatic hypotension and heart arrhythmias.
Diagnosis & Investigations
Some of the early symptoms of Guillain-Barré Syndrome may not be very specific and can vary from person to person. As such, diagnosis may be difficult in the early stages of the disease.
A detailed medical history and physical examination will need to be carried out. This is often followed by several tests, which may include a lumbar puncture and nerve function tests. Guillain-Barré Syndrome is generally managed by a neurologist.
Prognosis & Treatment
Most cases of Guillain-Barré Syndrome tend to progress as follows (although this can vary between individuals):
• Following the first symptoms of the disease, the condition tends to progressively worsen for about two weeks.
• Symptoms plateau within four weeks.
• Gradual recovery occurs over 6 to 12 months, although some may several years.
Whilst there is no cure for Guillain-Barré Syndrome, certain treatments have been shown to aid recovery and reduce the severity of symptoms.
Plasmapheresis:
Plasmapheresis is a process in which the fluid part of the blood, called the plasma, is separated from blood cells by a device known as a cell separator. The cells are returned to the patient, while the plasma, which contains the auto-antibodies, is discarded and replaced with other fluids. This treatment is also known as plasma exchange.
Intravenous immunoglobulin:
Intravenous immunoglobulin contains the pooled IgG (immunoglobulin (antibody) G) extracted from the plasma of donors. High doses of healthy immunoglobulins have been used in the treatment of conditions such as Guillain-Barré Syndrome, to help block the auto-antibodies from causing further damage.
Physiotherapists, occupational therapists and speech therapists will involved in the management of a patient with Guillain-Barré Syndrome. They will assist with stretching to keep muscles flexible, exercises to regain muscle strength, preventing bed sores, swallowing assessment, training with adaptive devices such as wheelchairs and walking aids etc.
Find a Neurologist
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.
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