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Guillain-Barre Syndrome
What Is Guillain-Barre Syndrome?
Guillain-Barre syndrome is a neurological disorder in which the body’s immune response attacks the peripheral nervous system – that is, the nerves that lie outside of the brain and spinal cord. It typically begins with a tingling sensation and feelings of weakness in the legs, and progresses quickly to more serious symptoms, including severe cramps, difficulty breathing, and paralysis. Extreme cases should be treated as medical emergencies. The cause of Guillain-Barre syndrome is unknown but its onset has been linked to certain types of viral and bacterial infections.
There is some good news regarding Guillain-Barre syndrome. First, it is a rare condition, affecting only about one in every 100,000 Americans, although men and persons over age 50 are at greater risk of developing it. Secondly, an estimated 85 percent of all patients recover from Guillain-Barre syndrome within a year, though some still experience periods of fatigue and other medical complications. Reoccurrence is highly unusual.
What Are the Symptoms of Guillain-Barre Syndrome?
Guillain-Barre syndrome is marked by the following symptoms:
- Tingling sensations in feet, legs, hands, and arms
- Weakness in the legs that makes standing or walking difficult
- Loss of control of eye or facial muscles
- Problems talking, chewing, swallowing, and breathing
- Cramping pains
- Accelerated heart rate
- Fluctuations in blood pressure
- Declines in bladder and bowel control
Symptoms of Guillain-Barre syndrome often come on quickly, peaking about two to four weeks after their initial appearance.
What Causes Guillain-Barre Syndrome?
The pain, fatigue, and dysfunction of Guillain-Barre syndrome result from attacks by the body’s immune system on the outlying nerves, rather than on pathogens and other genuine threats to health. These attacks rob the nerves of their effectiveness by stripping away a protective coating called the myelin sheath, reducing communication with the brain. Researchers are not clear on why the immune system should target the nerves. There is evidence tying the onset of Guillain-Barre symptoms to recent respiratory and digestive infections, along with the Zika virus, HIV, the Epstein-Barr virus, surgery, and, in rare cases, childhood vaccinations. Another common factor is infection by the campylobacter bacteria, found in undercooked chicken and poultry dishes.
There are actually three forms of Guillain-Barre syndrome:
- Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP): The most common form in the United States, AIDP is marked by tingling sensations and muscle weakness in the feet and legs that spread to the upper body.
- Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-sensory Axonal Neuropathy (AMSAN): This variant is more frequent in Mexico and several Asian countries.
- Miller Fisher Syndrome (MFS): This less-common form of Guillain-Barre syndrome first manifests in the eyes and other facial muscles.
How Is Guillain-Barre Syndrome Diagnosed?
The early symptoms of Guillain-Barre syndrome are similar to those of other neurological disorders and are therefore difficult to identify. Your physician will likely take the following steps to analyze your condition:
- Medical history and physical exam: Recording your symptoms, and the order in which they appeared, can provide your physician with insight into the possibility of Guillain-Barre syndrome.
- Spinal tap: Changes in your spinal fluid sometimes offer evidence for the presence of a neurological disorder.
- Nerve-conduction study: A study of this type measures the efficiency of nerves in passing signals to the brain. If nerve-conduction is poor, it might be a sign of Guillain-Barre.
- Electromyography: By inserting tiny electrodes in your muscles, your physician can gain valuable information on the volume of nerve activity.
How Is Guillain-Barre Syndrome Treated?
Most persons with Guillain-Barre syndrome eventually recover on their own, though the process can be slow and frustrating. There are, however, treatments that can assist in recovery and diminish the severity of your symptoms.
Plasma Exchange
Plasma exchange, or plasmapheresis, is a process by which antibodies active in attacking your nerves are eliminated from the bloodstream. Blood is removed from your body and divided into two parts: cells and the liquid they’re suspended in – plasma. Only the cells are returned to your body where they help to generate new plasma free of the immune agents driving the disorder.
Intravenous Immunoglobulin
Immunoglobulin is a source of antibodies or immune agents. Receiving doses of immunoglobulin from healthy donors can counteract the negative effects of antibodies attacking the nerves. Doses are delivered by means of injection, either intravenously or sometimes subcutaneously (under the skin).
Medications
Patients with Guillain-Barre syndrome typically receive medications for pain control and blood-clot prevention. The latter result from long periods of forced immobility.
Therapy
Physical therapy can help speed recovery during the rebound phase. Guillain-Barre sufferers may also receive training in crutches, braces, wheelchairs, and other types of durable medical equipment.
Complications of Guillain-Barre Syndrome
Though most persons with this disorder gradually get better, medical complications are a possibility. These include residual pain and numbness, high or low blood pressure, urinary and defecatory problems, blood clots, pressure sores, and breathing issues. Relapses occur but only very rarely.
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