Guillain-Barre Syndrome

Guillain-Barré (Ghee-yan Bah-ray) Syndrome, also called acute inflammatory demyelinating polyneuropathy and Landry’s ascending paralysis, is an inflammatory disorder of the peripheral nerves, those outside the brain and spinal cord. It is characterized by the rapid onset of weakness and often, paralysis of the legs, arms, breathing muscles and face. Abnormal sensations often accompany the weakness.

Many patients require an intensive care unit during the early course of their illness, especially if support of breathing with a machine is required. Although most people recover, this can take months, and some may have long term disabilities of varying degrees. Less than 5 percent die. GBS can develop in any person at any age, regardless of gender or ethnic background.

Quite often, the patient’s symptoms and physical exam are sufficient to indicate the diagnosis. The rapid onset of (ascending) weakness, frequently accompanied by abnormal sensations that affect both sides of the body similarly, is a common presenting picture. Loss of reflexes, such as the knee jerk, are usually found. To confirm the diagnosis, a lumbar puncture to find elevated fluid protein and electrical test of nerve and muscle function may be performed.

Because progression of the disease in its early stages is unpredictable, most newly diagnosed patients are hospitalized and usually placed in an intensive care unit to monitor breathing and other body functions. Care involves use of general supportive measures for the paralyzed patient, and also methods specifically designed to speed recovery, especially for those patients with major problems, such as inability to walk. Plasma exchange (a blood “cleansing” procedure) and high dose intravenous immune globulins are often helpful to shorten the course of GBS.

Most patients, after their early hospital stay and when medically stable, are candidates for a rehabilitation program to help learn optimal use of muscles as nerve supply returns.

The cause is not known. Perhaps 50% of cases occur shortly after a microbial (viral or bacterial) infection such as a sore throat or diarrhea. Many cases developed in people who received the 1976 swine flu vaccine. Some theories suggest an autoimmune mechanism, in which the patient’s defense system of antibodies and white blood cells are triggered into damaging the nerve covering or insulation, leading to weakness and abnormal sensation.

 


Signs, symptoms & indicators of Guillain-Barre Syndrome

Lab Values - Cells  

Low lymphocyte count




Guillain-Barre Syndrome could instead be

Infections  

Lyme Disease

Putting aside the issue of whether Lyme disease does or does not cause some cases of Guillain-Barre syndrome, the two diseases share so many symptoms that Lyme disease can be mistaken for Guillain-Barre syndrome.



Key

Weak or unproven link

Glossary

Acute

An illness or symptom of sudden onset, which generally has a short duration.

Protein

Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Diarrhea

Excessive discharge of contents of bowel.

Autoimmune Disease

One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Antibody

A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.

White Blood Cell

(WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.

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