Guillain-Barré syndrome (GBS) is a problem with your nervous system. It triggers muscle weakness, loss of reflexes, numbness or tingling in your legs, arms, face, and other parts of your body. Sometimes, this rare condition can cause paralysis and even death. In most cases, people are better and have few lasting problems.
Experts do not know what causes GBS. It is believed that the nerves are attacked by the body’s defense system (the immune system). It is called an autoimmune disease. In Guillain-Barré syndrome, the immune system itself attacks the covering of certain nerves, causing nerve damage.
Most people contract GBS after they have had a viral or bacterial infection, mainly an infection of the lungs, stomach, or intestines. Such infections may include:
- Campylobacter jejuni, which may cause a type of food poisoning.
- Cytomegalovirus (CMV), which may cause fever, chills, swollen glands, body aches, sore throat, and fatigue.
- Epstein-Barr virus (EBV), which may cause mononucleosis (mono).
- MycoplasmaMycoplasma, which may cause pneumonia.
- Varicella-zoster virus, which may cause shingles and chickenpox.
- Back pain.
- Not being able to move your eyes.
- Trouble in speaking, chewing and swallowing.
- Muscle weakness in your legs, arms, and the sides of your face.
- Numbness or tingling in your feet, hands, and sometimes around the mouth and lips.
The first symptom is numbness or tingling in the toes and fingers. Over several days, muscle weakness develops in the legs and arms. After about four weeks, most people begin to feel better. Treating in the hospital might be needed for the first few weeks since the condition can be fatal if weakness spreads to muscles that control breathing, blood pressure, and heart rate. Call your doctor right away if you think you might have Guillain-Barré syndrome.
Tell your doctor when your symptoms began and how they have changed. He may also ask if you have had any recent infections. Two signs are crucial in helping your doctor decide whether you have Guillain-Barré syndrome:
- Your legs and arms are becoming weaker.
- You are losing your reflexes (automatic body movements that you cannot control).
Your doctor may order tests, such as a lumbar puncture or a nerve conduction study. If the diagnosis is unclear, you may be referred to a physician who is well-versed in the nervous system (neurologist).
This syndrome is usually treated in the hospital. The healthcare staff will watch you carefully to make sure you do not get worse or get an infection. Your breathing, blood pressure, and heart rate will be closely tracked. Some patients need a ventilator to help them breathe.
There are two treatments that may help your body fight the disease. They can also speed your recovery if conducted when you first get sick.
- In a plasma exchange, blood is removed from your body. The harmful antibodies are taken out of the blood, and then the blood is returned to your body.
- In intravenous immune globulin (IVIG), helpful antibodies are added to your blood.
You need to stay in the hospital for weeks until your symptoms have faded. Sometimes this condition comes back. Both plasma exchange and IVIG therapy are necessary to reduce the severity of a relapse.
It takes 3-6 months or longer to recover and several months before one can return to his regular activities. Many people suffer long-term effects, such as numbness in toes and fingers. Quite often, these problems do not bother their daily lives. Some people experience more severe problems, such as balance problems or long-term weakness.
Support at home is essential during this time. You might need help with some of your chores until you are better. Regular exercise can contribute to strengthening your weakened muscles. If you have severe muscle weakness or paralysis, you may need physical or occupational therapy.
Some people will not recover fully from Guillain-Barré syndrome and up to 20% of patients still experience muscle weakness after three years. Potential long-term complications include:
- muscle weakness in arms or legs
- loss of balance
- not being able to walk – for example, needing a wheelchair
- loss of sensation that may cause a lack of co-ordination
- problems with their sense of touch – often felt a burning or tingling sensation
Some people with GBS also experience persistent fatigue or extreme tiredness. Complications can be life-threatening in rare cases, particularly in the acute phase when the patient is most unwell.
Guillain-Barré syndrome can make a devastating disorder due to its sudden and unexpected onset. Furthermore, recovery is not necessarily quick. As mentioned above, patients usually reach the point of highest weakness or paralysis several days or weeks after the first symptoms appear. Symptoms then settle at this level for a few days, weeks, or even months. The recovery period might be as little as several weeks or as long as several years. About thirty percent of patients with Guillain-Barré still suffer a residual weakness after three years. About three percent may have a relapse of muscle weakness and tingling sensations years after the initial attack.
Scientists are focusing on finding new treatments and upgrading existing ones. They are also looking at workings of the immune system to determine which cells are responsible for initiating and carrying out the attack on the nervous system. So many cases of GBS begin after a viral or bacterial infection lead to a theory that perhaps certain characteristics of some viruses and bacteria activate the immune system improperly. Investigators are seeking those characteristics. Immunologists, neurological scientists, virologists, and pharmacologists are working collaboratively to figure out how to prevent this disorder and to invent better therapies available when it strikes.
Who Is Affected?
Guillain-Barré syndrome is rare, afflicting only about one person in 100,000. It affects more men than women and can happen at any age. However, it is most common in adults between the ages of 30-50 years. Occasionally surgery may trigger the syndrome. Vaccinations, in rare instances, may increase the risk of Guillain-Barre infection. No cure is available for Guillain-Barre, but most people spontaneously fully recover. Recovery can be slow, lasting from several weeks to several years.
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