Guillain-Barre Syndrome
What is it?
Guillain-Barre syndrome (GBS) is a rare disorder of the nervous system that causes rapidly progressing muscle weakness that, in severe cases, can result in paralysis. With
GBS, the body’s immune system begins to attack the body itself. Symptoms may develop over a period of days or up to three or four weeks, usually after a mild infection, surgery, or immunization.
Who gets it?
It is not clear why some people develop GBS and others don’t. Researchers have found that, among those with
GBS, the most common infections that preceded the GBS symptoms were
cytomegalovirus, herpes, Epstein-Barr virus, and viral hepatitis. People who have had a gastrointestinal infection from the bacteria known as Campylobacter jejuni may get a severe type of
GBS. People with AIDS, lymphoma, or systemic lupus erythematosus also have a higher risk of developing
GBS. People who have had recent surgical procedures account for only about 5% of GBS patients. While some patients have developed GBS after receiving an immunization, this has not been seen in great numbers since the Swine flu vaccine in 1976-1977.
What causes it?
The symptoms of GBS are caused by a loss of myelin, an insulating material that is wrapped around the nerve cells. Myelin helps keep nerve impulses moving through the nerves. For reasons unknown, the body’s immune system becomes confused and the myelin around the nerves becomes its target for destruction. When the myelin is lost, nerve impulses slow down or stop altogether. Because the people who develop GBS often do so after a mild infection, surgery, or immunization, it seems that these events trigger the body’s immune system to respond in this way. However, some people develop GBS with no apparent preceding cause.
What are the symptoms?
GBS usually begins with muscle weakness, tingling, and loss of sensation in the legs. These symptoms progress to the arms and then to the face, with symptoms affecting both sides of the body at the same time. Within a short time, normal reflexes are lost. The symptoms can increase until the muscles cannot be used at all and the patient is almost totally paralyzed. In the majority of patients, the most intense weakness occurs within the first two weeks. In severe cases, the muscles needed for breathing and swallowing become so weak that the patient cannot perform these functions unassisted.
How is it diagnosed?
Doctors look for a pattern of symptoms—progressive muscle weakness leading to paralysis—to diagnose
GBS. The fact that these symptoms affect both sides of the body can help eliminate other causes with similar symptoms. However, to rule out other disorders, your doctor may order a spinal tap. People with GBS have high protein levels in the cerebrospinal fluid. Electrodiagnostic studies are also used to test the function of the nerve endings.
What is the treatment?
There is no treatment to stop the progress of
GBS. Symptoms must be carefully monitored so patients with difficulty breathing receive respirator assistance and patients with swallowing difficulties receive intravenous fluids. It is also important to monitor cardiac functions, including heart rate, rhythm, and blood pressure. The best treatment for GBS is a procedure called
plasmapheresis. The patient’s blood is withdrawn and filtered of toxic substances that might be attacking the myelin. Another effective treatment is an intravenous solution of autoimmune globulin. Immunoglobulin is naturally manufactured by everyone’s immune system to respond to toxins, bacteria, and foreign cells. For GBS patients with paralysis, physical therapy and frequent turning can help prevent muscle tightening and bedsores. While GBS can be life threatening, most patients recover with treatment. About 30% of adult patients and a larger percentage of children experience some degree of muscle weakness as a side effect. Recovery can take anywhere from a few weeks to a few years, depending upon the severity of the symptoms and how quickly treatment begins. The elderly are most threatened by
GBS.
Self-care tips
Because the exact cause of GBS cannot be pinpointed, there is no known way to prevent it. However, it’s important to seek immediate medical treatment for any symptoms of muscle weakness and loss of reflexes. Early treatment improves the outlook for recovery.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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