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Guillian-Barre Syndrome

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Guillian-Barre Syndrome

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Guillain-Barre syndrome is a rare disorder where the immune system attacks the peripheral nerve cells. Read the article to know more.

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Published At December 6, 2013
Reviewed AtFebruary 29, 2024

Introduction:

Guillain-Barre Syndrome, though a very rare disease, has serious manifestations and occurs mostly during adulthood rather than childhood. Guillain-Barre syndrome is a manifestation of a virus affecting the nerves and is a peripheral nerve disorder. Its symptoms are diagnosed by a sudden weakness in the limbs where the virus may have attacked and gradually covered other peripheral areas if not started medications immediately. The patient has to be confined to a hospital as soon as the symptoms appear.

What Is Meant by Guillain-Barre Syndrome?

Guillain-Barre syndrome is an autoimmune disorder, where the normal cells are attacked by the body’s immune system. In the case of Guillain-Barre syndrome, the body’s immune system attacks the nervous system, which results in loss of control of muscle which leads to muscle weakness and numbness or tingling sensation.

What Are the Types of Guillain-Barre Syndrome?

Guillain-Barre syndrome manifests in various ways. The primary kinds are:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) - It is the most prevalent type. Muscle weakness that begins in the lower body and moves upward is the most typical symptom of AIDP.

  • Miller-Fisher Syndrome (MFS) - In this syndrome, weakness begins in the eyes.

  • Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-Sensory Axonal Neuropathy (AMSAN) - These are the Guillain-Barre syndrome axonal subtypes.

What Are the Causes of Guillain-Barre Syndrome?

Guillain-Barre syndrome is usually caused by a viral or bacterial infection, rarely the bacterial and viral protein can be similar to the body’s protein. When it occurs the body’s immune system gets confused and starts to attack the body. When the nervous system is attacked by the immune system it causes Guillain-Barre syndrome.

What Are the Signs and Symptoms of Guillain-Barre Syndrome?

  • Weakness in the affected area.

  • Mild paralysis.

  • Sensory loss in the affected area and pain.

  • Other symptoms include sweating, palpitations, and blood pressure.

  • Numbness or tingling sensation.

  • Breathing issues.

  • Problem with swallowing.

What Is the Diagnosis Method of Guillain-Barre Syndrome?

Diagnosis of Guillain-Barre syndrome depends on the symptoms. Neurological examination is done by the doctors. The doctor will recommend other tests to rule out any other condition with similar symptoms.

Some of the tests done to diagnose Guillain-Barre syndrome are:

  • Spinal Tap or Lumbar Puncture: In this procedure, the cerebrospinal fluid present around the spinal cord and the brain is taken as a sample. During the procedure, a thin needle is slid through the back, which collects a small amount of cerebrospinal fluid and is sent for analysis. This test is performed to rule out any other condition with similar symptoms of Guillain-Barre syndrome like nervous system infection.

  • Electromyography (EMG): Thin needle electrodes are inserted into the muscle which helps to track the nerve function.

  • Nerve Conduction Study: Above the nerves, electrodes are secured to the skin. To gauge the rapidity of nerve signals, a tiny shock is delivered through the nerve.

  • Needle Electromyography: This test is done to monitor the health and functioning of the nerves and muscles. As Guillain-Barre syndrome damages the nerves, this procedure can help doctors in diagnosing Guillain-Barre syndrome.

How Is Guillain-Barre Syndrome Managed?

The symptoms related to Guillain-Barre syndrome escalate very quickly and result in hospitalization of the person for emergency treatment. Two modes of treatment help in the quick recovery from Guillain-Barre syndrome:

  • Intravenous Immunoglobulin Therapy (IVIG): In this mode of treatment, infusion of antibodies is done, which are the proteins that the body utilizes to fight foreign substances. This has been collected from tens and thousands of people. This infusion of antibodies helps to calm down the immune system which attacks the nervous system.

  • Plasma Exchange or Plasmapheresis: In this procedure, the liquid part of the blood called the plasma is filtered. During this filtration process, the antibodies that attack the nerves that are present in the blood are removed, and the cleared plasma without any antibodies is returned to the body. This prevents the body’s immune system from attacking the nervous system.

What Is the Prognosis of Guillain-Barre Syndrome?

  • The prognosis of the disease starts around the fourth week. With other medications to support the severity of the virus affecting the body, it is also essential to improve muscle wasting, build up chest muscles, and help the patient recover physically.

  • Physical therapy plays an important role in helping recover from the physical manifestations of this disease. Physiotherapy can be started after four weeks of its prognosis. Patients can be continued with full ROM (range of motion) every day to prevent joint contractures and muscle shortening. With the help of muscle-strengthening exercises, the lost vitality of the muscles can be brought back.

  • Isometric and Isokinetic exercises activate muscle strengthening and help to regain posture and build up chest muscles to avoid breathing muscles from collapsing.

  • Physiotherapy also teaches mobility, bed transfers, and ambulation with minimal help.

  • Gradual gait training (training a patient how to walk safely) is taught with the help of crutches and other walking aids to enable the patient to walk independently.

  • Physiotherapy also revises the need for orthotic management. Overall functional recovery is initiated with the help of physiotherapy.

What Is the Long-Term Effect of Guillain-Barre Syndrome?

Most people affected by this condition recover completely, but some continue to have signs and symptoms like muscle weakness, walking difficulties, and numbness or tingling effects. A few people affected may require a walker or wheelchair.

What Are the Possible Complications of Guillain-Barre Syndrome?

Dysautonomia linked to GBS can cause the following complications:

  • Cardiac anomalies.

  • Blood pressure instability.

  • Problems with digestion.

  • Urinary retention and other bladder control problems.

When to Visit a Physician?

If individuals experience a slight tingling sensation in their fingers or toes, they have to consult a physician. If any of the following severe symptoms arise, visit a physician immediately.

  • Weakness or tingling that spreads quickly.

  • Breathlessness or difficulty breathing while lying flat.

  • Tingling in the feet or toes that is currently spreading throughout the entire body.

  • Saliva-induced choking.

Is Guillain-Barre Syndrome Preventable?

Guillain-Barre syndrome cannot be prevented. One can reduce the risk of the condition by maintaining the general health. Some of the steps to reduce the possibility are -

  • Hands-wash frequently.

  • Stay away from people who are infected or who have the stomach flu.

  • Maintain a healthy diet to strengthen the immune system.

  • Exercise regularly.

  • Make sure to take all the vaccinations.

Conclusion:

Guillain-Barre syndrome is an autoimmune disorder, which means the nerves of the body are being attacked by the body’s immune system. This results in muscle weakness, numbness, and a tingling effect. This condition needs to be diagnosed and treated immediately or else it may result in severe symptoms like paralysis, difficulty breathing, and alteration in blood pressure and heart rate, if not treated can result in death. When treated properly, most people recover quickly.

Frequently Asked Questions

1.

What Is the Cause for Guillain-Barre Syndrome?

The exact cause of Guillain-Barre syndrome is not known. The commonest variant is acute inflammatory demyelinating polyneuropathy (AIDP). About two-thirds of those with AIDP have a prior history of infection and an autoimmune response triggered by the preceding infection, which causes demyelination. This disorder occurs after the occurence of respiratory tract infections and digestive tract infections. It is said that vaccinations and recent surgery can trigger Guillain-Barre syndrome.

2.

Is Guillain-Barre Syndrome Permanent?

People with Guillain-Barre syndrome recover fully, but sometimes it takes a longer time to get out of this problem. One in five people experience long-term effects, some people experience symptoms again after years, and some have permanent nerve damage.

3.

What Happens In Guillain-Barre Syndrome?

Guillain-Barre syndrome is a heterogeneous group of immune-mediated conditions which affect the nerve and myelin sheath. Distal paraesthesia, facial and bulbar weakness commonly develop, and respiratory weakness requiring ventilatory support occurs in 20% of cases.

4.

Who Is At Risk for Guillain-Barre Syndrome?

Guillain-Barre syndrome occurs at any age but are frequently seen in adults and elderly people. The incidence of Guillain-Barre syndrome is 1-2/100000/year. It occurs in both sexes and are more found in patients with neurological disease.

5.

How Is the Pain During Guillain-Barre Syndrome?

The pain precedes muscle weakness that ascends rapidly from lower to upper limbs and is more marked proximally than distally in distal paraesthesia. People experience severe nerve pain, urine retention, improper bowel function, and bladder problems during Guillain-Barre syndrome.

6.

What Is the Treatment for Guillain-Barre Syndrome?

Regular monitoring of respiratory function is needed in the acute phase, as respiratory failure may develop with little warning. Active treatment with plasma exchange or intravenous (IV) immunoglobulin therapy shortens the duration of ventilation and improves the prognosis.

7.

How Do You Diagnose Guillain-Barre Syndrome?

Guillain-Barre syndrome is difficult to diagnose at the early stages as it does show any symptoms and cannot be identified at the earliest. The lumbar puncture or spinal tap, electromyography (nerve function test), nerve conduction tests helps to diagnose Guillain-Barre syndrome.

8.

Does Guillain-Barre Syndrome Affect the Brain?

Guillain-Barre syndrome affects the brain by damaging the myelin sheath. Myelin sheath is the layer that protects the nerves. Damage in the nerves prevents the transmission of signals to the brain resulting in paresthesia, mainly distal paresthesia, weakness, and numbness in the brain.

9.

What Are the Long-Term Effects of Guillain-Barre Syndrome?

Patients experience numbness, weakness, fatigue, and it takes six months for the people to walk after Guillain Barre syndrome. Overall, 80% of the people recover completely within three to six months, 4% of the people die, and the remainder suffers a residual neurological disability which can be adverse.

10.

What Is the Duration of Guillain-Barre Syndrome?

During the early stages, it is difficult to identify the condition. After we identify with signs and symptoms, the condition starts to worsen. Within four weeks, it reaches the stage where there is no further change or development. The condition lasts for a year and in some people for three years, after which recovery occurs.
Shwetanjali Gandhe
Shwetanjali Gandhe

Physiotherapy

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guillian barre syndromesensory lossphysical therapyphysiotherapyparalysis
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