Guillain-Barre Syndrome: Information on Causes, Diagnosis & Treatments
Guillain-Barre syndrome (GBS) involves an immune system disorder that attacks the peripheral nervous system. Early-onset of the disorder often causes varying degrees of overall body weakness and a tingling sensation in the lower extremities. Sometimes, the disorder presents itself as a symmetrical weakness that will eventually spread to the upper body and arms. In many cases, the symptoms will intensify to the point where specific muscle groups are unable to be used. In severe cases, the individual becomes nearly completely paralyzed.
The disorder can be life-threatening because it interferes with breathing functions, heart rate, and blood pressure. In nearly all cases the syndrome creates a medical emergency requiring the individual to be placed on a ventilator to assist in breathing function or be closely monitored for infections, abnormal heart rate, low or high blood pressure, blood clots and other complications. In time, many individuals will nearly fully recover. In a few cases, the patient will live a lifetime with some degree of weakness.
- What Causes Guillain-Barre Syndrome?
- Who Is at Risk for the Disorder?
- Common Symptoms
- Classifying Guillain-Barre
- Diagnosing Guillain-Barre
- Guillain-Barre Treatments
Who Is at Risk for Guillain-Barre?
Nearly anyone can be affected by Guillain-Barre syndrome that can strike either gender at any age. However, the syndrome is extremely rare and afflicts approximately one out of every 100,000 individuals. The disorder can occur over a few days or take weeks to display the most common symptoms including gastrointestinal or respiratory viral infection. Sometimes, surgical procedures trigger the syndrome. In recent years, scientists have found that virus and some vaccinations increase the incident rate of Guillain-Barré syndrome.
The most common Guillain-Barré risk factors affecting every age group involve:
- Gender – Men are more likely to develop the disorder that women
- Age – Older adults tend to be at risk of developing the syndrome
- Exposure to viruses including influenza, Epstein-Barr, and campylobacter that is usually acquired from undercooked poultry
- Cytomegalovirus (a herpesvirus strain)
- HIV or Aids sufferers
- Mycoplasma Pneumonia caused by bacteria like organisms
- Individuals with Hodgkin's lymphoma
- Surgical procedures
- Rarely childhood vaccinations and influenza vaccines
What Causes Guillain-Barre Syndrome?
Scientists and doctors have yet to determine the exact cause of Guillain-Barré syndrome that can develop days or weeks after suffering a digestive tract or respiratory infection. In some cases, immunizations and surgical procedures can trigger the syndrome to develop.
The syndrome develops when the immune system attacks the nervous system instead of invading organisms and caused considerable damage to the myelin sheath (the nerve‘s protective covering). This damage prevents transmission between nerve cells that linked muscles and tissue to the brain. The damage eventually results in numbness, overall weakness and/or paralysis.
Approximately ten percent of all individuals who suffer from the syndrome will begin felling symptoms in the face or arms that include muscle weakness. The most common Guillain-Barré symptoms include:
- Pins and needles prickling sensation felt in the fingers, toes, wrists, and/or ankles.
- Rapid heart rate
- Difficulty in breathing
- High or low blood pressure
- Severe pain that produces cramps and aches that worsen at night
- Unstable walking
- The inability to climb stairs
- Weakness that begins in the lower extremities and spreads to the upper body
- Difficulty with bowel and bladder function
- Difficulty with facial movements including swallowing, chewing and speaking
Individuals who suffer from the syndrome typically experience the most aggressive forms of the symptoms occur within the first two to four weeks after the initial symptoms appear. Partial recovery can begin within the first month after the weakness stabilizes.
Acquiring the condition can be a serious medical emergency that requires immediate hospitalization. This is because the symptoms often worsen rapidly. The sooner the patient can receive appropriate treatment the better the chance they will experience a desirable outcome.
Scientists once thought that Guillain-Barre syndrome was a single disorder. However, they now know there are three specific categories of the disorder that include:
- Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) – This form most commonly occurs in America and often involves overall muscle weakness the begins in the lower extremities and spreads upwards.
- Acute Motor Axonal Neuropathy or Acute Motor-Sensory Axonal Neuropathy – This form is less common in America and more frequently seen in Mexico, Japan, and China.
- Miller Fisher Syndrome (MFS) – This form involves paralysis beginning in the eyes and eventually produces an unsteady gait. Only approximate five percent of the cases of this form of Guillain-Barre syndrome occurs in America. But is more common in Asian countries.
Doctors are often challenged when diagnosing Guillain-Barre syndrome in its initial stage. This is because the most common symptoms are very similar to other neurological disorders. Verifying a diagnosis usually requires gathering a comprehensive personal medical history followed by a thorough physical exam. In addition, the doctor typically recommends the patient undergo other procedures including:
- Electromyography – Using thin needle electrodes, the doctor inserts the needle into the muscle group to measure nerve activity.
- Lumbar Puncture (Spinal Tap) – The doctor can withdraw tiny amounts of spinal fluid from the spinal canal in the lower the back. The fluid will then be tested by a pathologist who can rule out or verified the presence of the disorder.
- Nerve Conduction –Small electrical shocks pass through electrodes that are taped to the skin just above the affected nerves can measure the transmission speed of traveling nerve signals.
Any individual suffering from the syndrome should be immediately admitted to a hospital or medical center for close observation. This is because the symptoms often become significantly worse very rapidly which could be fatal if left untreated. Paralysis is a common result in the most severe cases that can produce life-threatening complications if it affects the chest muscles or diaphragm to prevent proper breathing.
There is no cure for Guillain-Barre syndrome. Instead of curing the disease, doctors focus on lessening the symptoms severity and maintain body function to ensure that the nervous system will recover. Common treatments include:
- Plasma Exchange (Plasmapheresis) – Normally, the immune system produces antibodies (proteins) that can attack dangerous foreign substances including viruses and bacteria. However, Guillain-Barre syndrome causes the immune system to misguidedly make antibodies that seek out and destroy healthy nerves throughout the nervous system. Through plasmapheresis, a machine removed blood from the body and returns it after removing the harmful antibodies.
- Intravenous Immunoglobulin – The doctor will recommend injecting high doses of immunoglobulin (donated healthy, normal antibodies) to block the formation of harmful antibodies that are made by the syndrome.
The doctor might also prescribe medication that relieves pain and prevents the development of blood clots due to the patient's immobility. Physical therapy is often an option during the recovery process to help arm and leg function by keeping them flexible. Once the patient has partially or fully recovered, they can begin strengthening their muscles through routine exercise.
Recovering from Guillain-Barre syndrome can take time. However, most individuals fully recover. Initially, partial recovery takes 2 to 4 weeks before most symptoms stabilized and full recovery can take between 6 to 12 months on average. The condition can be life-threatening without treatment especially in the elderly, or treatment is delayed, the illnesses allowed the progress rapidly or the patient remains on our respirator for an extended period.