Table of Content:
- What is Guillain barre syndrome?
- Risk Factors & Complications
- How is it Diagnosed?
What is Guillain Barre syndrome?
Guillain Barre syndrome is a rare serious condition that affects the nerves. The body’s immune system attacks the nerves causing problems like numbness, weakness, and pain. These sensations quickly spread to the entire body, eventually leading to total paralysis. Though this condition has no known causes, most patients report a respiratory or gastrointestinal viral infection in the recent past.
Causes of Guillain-Barre syndrome
GBS syndrome usually appears days or weeks after a respiratory or gastrointestinal viral infection. Guillain Barre syndrome has even been reported following a Zika virus or COVID-19 infection. The immune system which usually attacks invading organisms, attacks the nerves in this condition that leads to damage to the nerves causing symptoms such as weakness, numbness, and paralysis.
Types of Guillain-Barre syndrome
Guillain-Barre syndrome can occur in several forms. The main types include:
- Acute inflammatory demyelinating polyradiculoneuropathy (AIDP). In this type, weakness begins from the lower limbs and spreads upwards.
- Miller Fisher syndrome (MFS). MFS begins with a palsy of the muscles of the eyes and is also associated with an unsteady gait.
- Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN). These variants are more common in Mexico, China, and Japan.
Guillain-Barre syndrome symptoms
Guillain-Barre syndrome usually begins with tingling and weakness in the feet and legs and spreads to the upper part of the body. As the disease progresses, the weakness develops into paralysis.
Signs and symptoms include:
- Pins and needles sensation in your fingers, wrists, ankles and toes.
- Weakness beginning from your legs that spreads up.
- Unsteady gait, or inability to climb stairs
- Blurred or double vision or inability to move your eyes.
- Cramp-like severe pain that may worsen at night
- Difficulty in breathing
- Raised or low blood pressure
- Rapid heart rate
It is important to get immediate medical attention if you develop symptoms such as difficulty in breathing, swallowing or speaking. Any inability to move your hands or feet also signal a medical emergency.
Recovery time of Guillain-Barre syndrome
Though rarely Guillain-Barre syndrome can take several months or years to recover, most people follow a similar pattern. After the initial signs of Guillain-Barre syndrome, patients find their symptoms progressively worsening for two weeks, after which they plateau within four weeks. Recovery soon follows, and symptoms completely resolve within six months to a year for most people. Children recover more completely when compared to adults with Guillain-Barre syndrome.
Risk factors associated with Guillain-Barre syndrome
Guillain-Barre syndrome can affect all age groups, however, your risk increases with age. It is also more common in males than in females. Guillain-Barre syndrome may be triggered by conditions such as:
- Recent infection by viruses such as the Influenza virus, CMV, EBV, Zika virus, Hepatitis A, B, C, E, HIV and even the COVID-19 infection.
- Recent surgery
- Hodgkin lymphoma
Complications of Guillain-Barre syndrome
Since Guillain-Barre syndrome affects your nerves which play a role in movements and body functions, people affected by it may suffer from the following complications:
- Difficulty in breathing. Weakness or paralysis can involve the muscles required for breathing, which can be fatal. Such people end up requiring assistive devices to breathe, although most often only for a temporary period of time.
- Residual numbness or weakness. Occasionally, after complete recovery, people may have minor residual weakness, numbness, or tingling.
- Heart and blood pressure problems. Arrhythmias and variations in blood pressure are common side-effects of Guillain-Barre syndrome.
- Up to a third of the people with Guillain-Barre syndrome report severe pain, which can be controlled by medication.
- Bowel and bladder dysfunction. Urine retention and sluggish bowel movements are complications of Guillain-Barre syndrome.
- Blood clots. Immobility due to muscle weakness or paralysis can put you at risk of developing blood clots. Use blood thinners and stockings to prevent the formation of clots.
- Two to five percent of people with Guillain-Barre syndrome experience a relapse of symptoms after resolution.
- Pressure sores. Immobility can also cause bed sores. Frequent repositioning prevents sores.
- Rarely, death can occur due to respiratory failure or heart attack.
How is Guillain-Barre syndrome Diagnosed?
Guillain-Barre syndrome is difficult to diagnose in the earlier stages as it mimics other neurological disorders. After obtaining your medical history and a thorough physical examination, your treating physician may require you to undergo a few tests:
- Spinal tap or a lumbar puncture. The fluid within the spinal canal is analysed for confirmation of Guillain-Barre syndrome.
- Nerve conduction studies. Electrodes are pasted on to your skin above the serves to detect the speed of conduction of signals.
Treatment of Guillain-Barre syndrome
- Plasmapheresis, or plasma exchange is done by removing blood from the body, separating the fluid (plasma) from the blood cells, and returning the cells back into the body. The body then manufactures new plasma to replace the lost fluid. This procedure works by removing certain antibodies in the plasma that play a role in the attacking of the nerves by the immune system.
- Immunoglobulin therapy. Immunoglobulin is obtained from the plasma of healthy individuals and is then injected into patients. Large quantities of immunoglobulin prevent damage to the nerves by blocking the attacking antibodies.
- Medical therapy. Medications prescribed for patients with Guillain-Barre syndrome are for pain relief and to prevent the formation of blood clots, which may develop due to restricted mobility.
- Physiotherapy for Guillain-Barre syndrome. A physiotherapist helps by training you to keep your muscles strong and flexible. Physical therapy also aids in coping with fatigue and regaining strength in weakened muscles. Adaptive devices such as walking sticks and wheelchairs help with mobility and self-care.
- Speech therapy. Speech and language therapy help to cope with long-term symptoms related to facial muscle weakness.
Dr. Vikram Huded | Senior Consultant – Neurology | Mazumdar Shaw Medical Center, Bangalore