Guillain-Barré syndrome is a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body.
These symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency. The patient is often put on a ventilator to assist with breathing.
Most patients, however, recover from even the most severe cases of Guillain-Barré syndrome GBS), although some continue to have some degree of weakness. Guillain-Barré syndrome is rare. Usually Guillain-Barré occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection.
Occasionally, surgery will trigger the syndrome. In rare instances, vaccinations may increase the risk of GBS. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks. No one yet knows why Guillain-Barré strikes some people and not others or what sets the disease in motion. What scientists do know is that the body's immune system begins to attack the body itself, causing what is known as an autoimmune disease.
Guillain-Barré is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. Reflexes such as knee jerks are usually lost. Because the signals traveling along the nerve are slower, a nerve conduction velocity (NCV) test can give a doctor clues to aid the diagnosis. The cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual, so a physician may decide to perform a spinal tap.
CAUSES Guillain-Barré syndrome is not hereditary or contagious. What causes GBS is not known; however, in about half of all cases the onset of the syndrome follows a viral or bacterial infection, such as the following:flu, common cold, gastrointestinal, viral infection, infectious mononucleosis, viral hepatitis, campylobacteriosis (usually from eating undercooked poultry), porphyria (rare disease of red blood cells).A small number of cases have been known to occur after a medical procedure, such as minor surgery. Vaccinations may also precipitate its onset eg. Flu vaccines & possibly gardisal (cervical cancer vaccine).
DR JEAN ALEXANDRE BARRE
DR GEORGES GULLAIN
The first symptoms of GBS are usually numbness or tingling (paresthesia) in the toes and fingers, with progressive weakness in the arms and legs over the next few days. Some patients experience paresthesia only in their toes and legs; others only experience symptoms on one side of the body. The symptoms may stay in this phase, causing only mild difficulty in walking, requiring crutches or a walking stick. However, sometimes the illness progresses, leading to complete paralysis of the arms and legs. About one quarter of the time, the paralysis continues up the chest and freezes the breathing muscles, leaving the patient dependent on a ventilator. If the swallowing muscles are also affected, a feeding tube may be needed. Back pain affects around 30%. Facial muscles and breathing can also be affected.
In CIDP, the course of illness is longer and respiratory failure is much more unlikely.
Patients recovery time may vary considerably, but although usually a slow healing process, the overall outlook is optimistic. Up to 95% of patients reach nearly complete recovery. A small percentage of patients have mild abnormalities that will not interfere with long term function. Others may have more severe, long-term disabilities that prevent them from returning to their prior lifestyle. Relapses are not common but do occur in a small number of patients, but the symptoms are often milder