Guillain Barre Syndrome (GBS)
GBS Symptoms | Causes
of GBS | GBS
Treatment | GBS Cure | GBS
Research
Guillain Barre Syndrome (GBS) is a disorder characterized by progressive
symmetrical paralysis and loss of reflexes, usually beginning in the
legs. The paralysis characteristically involves more than one limb (most
commonly the legs), is progressive, and is usually proceeds from the
end of an extremity toward the torso. Areflexia (loss of reflexes) or
hyporeflexia (diminution of reflexes) may occur in the arms and legs.
Guillain-Barre syndrome is not associated
with fever, an important fact in differentiating Guillain-Barre from
other diseases. Guillain-Barre usually occurs after a respiratory or
gastrointestinal infection,and is apparently caused by a misdirected
immune
response that results in the direct destruction of the myelin sheath surrounding the peripheral
nerves or of the axon of the nerve itself. The syndrome sometimes follows other triggering events, including
vaccinations. Among the vaccines reportedly associated with Guillain-Barre
syndrome are the 1976-1977 swine
flu vaccine, oral poliovirus vaccine,
and tetanus toxoid.
GBS Symptoms
The first symptoms of Guillain-Barre Syndrome (pronounced Ghee-lan Bar-ray)
are usually tingling and numbness in the fingers and toes. These symptoms
then progress and cause progressive weakness in the arms and legs during
the next few days. In the mildest of cases, the weakness may arrest and
cause only moderate difficulty in walking, requiring sticks, crutches
or a walking frame.
In some cases the weakness progresses and leads to
complete paralysis of the legs, the arms may also be affected. In a quarter
of cases the paralysis progresses up the chest and the patient is unable
to breathe on his or her own and needs to rely on a mechanical breathing
machine (ventilator). The throat and face may be affected making swallowing
impossible and so the patient needs to be fed by tube up the nose or
directly into the stomach. Most patients will reach their worst point
within two weeks.
The disease can be diagnosed clinically. However two
additional tests are usually performed to confirm the diagnosis. A EMG/NCS
allows the physician to see how the nerves are working to support the
diagnosis. A lumbar puncture allows the physician to rule out other diseases
that can mimic GBS.
GBS Cause
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Nerve Conduction Studies Showing Demyelination |
There is much research into the causes of GBS. About sixty percent of
patients suffer from a throat or intestinal infection within the week
or two prior to developing GBS. It is believed that one’s immune system
tries to fight this infection but develops antibodies which also react
against nerve. In some cases in which the preceding infection is a intestinal
illness with campylobacter jejuni specific antibodies against GM-1 can
be identified in the blood of patients. In other patients no specific
antibody is discovered. In either case there is a direct attack on the
insulation around the nerves, which is called myelin. This myelin is
stripped off of the nerves and therefore the nerves cannot conduct electricity
which leads to weakness.
GBS Treatment
The treatment in the early stages of Guillain-Barre Syndrome are designed
to shorten the course of the disease. There are two ways to treat GBS.
One can use plasmaphresis. This is a process of removing the antibodies
from a patient’s blood in a manner very similar to dialysis. Most patients
receive five courses of plasmaphresis and then no additional therapy.
The other treatment involves receiving intravenous
gammaglobulin. Most
studies indicate that these two treatments have essentially the same
efficacy.
GBS improves spontaneously. However, certain factors can assist
recovery:
- good nursing and medical/intensive care;
- physiotherapy to relieve
discomfort and prevent stiffness;
- immunoglobulin — the infusion of immunoglobulin
proves successful with similar results to plasmapheresis;
- plasmapheresis
— the exchange of blood plasma generally reduces the duration of the
disease in severe cases if carried out in the first few days; and
- counselling
to reassure the patient and encourage the patient towards recovery
GBS Cure
Left untreated patient’s will regrow their myelin around their nerves
over the course of 3 months to 3 years depending on the severity of the
disease. Once the patient has had a chance to recover GBS almost never
occurs again; however small percentages may later develop CIDP.
GBS Research
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