What is Guillain-Barre Syndrome?

Guillain-Barre Syndrome is a rare neurological condition in which the body's immune system attacks the nerves. In most cases, the first signs and symptoms of this disorder are tingling, weakness and numbness in the body's extremities. The sensations can quickly spread throughout the body, eventually causing paralysis of the entire body.

The exact cause of Guillain-Barre Syndrome is not clearly known, therefore it is hard for doctors to determine who is at risk of developing this disorder. What is known is that the onset of Guillain-Barre Syndrome often follows an infectious illness such as the flu or a respiratory infection. It is believed that the infection causes the body's immune system to react abnormally and attack the nerves. In about 60% of all cases of Guillain-Barre Syndrome, an infection in the lungs or digestive tract were present before the onset of symptoms, or a bacterial infection such as salmonella. It is unknown why some people develop Guillain-Barre Syndrome and others who have had the same infections do not. It is believed that the infection, whether viral or bacterial, causes the immune system to damage the protective covering of the body's peripheral nerves. The peripheral nerves control the body's sense and movement. The damage to the nerves then causes an inability of the nerves to send signals to the body's muscles. The lack of signals then causes the body to feel a tingling sensation, weakness, and eventually, short-term paralysis.

Symptoms of Guillain-Barre Syndrome are instability, numbness of the extremities, or numbness in the legs that spreads upward throughout the body, muscle weakness that gets progressively worse, a stinging sensation, unsteady gait when walking or the inability to walk at all. Later symptoms that may appear as Guillain-Barre Syndrome becomes worse are; difficulty chewing, swallowing, digesting food or controlling the bladder, difficulty with eye movement and/or speech, low pulse or blood pressure, temporary paralysis of the face, arms, legs and/or muscles that control breathing and severe pain in the lower back.

Guillain-Barre Syndrome can be fatal. If paralysis effects the muscles that control breathing, the person cannot breathe on their own. If this happens, the person must be put on a ventilator that will breathe for them until they regain muscle control. If not caught quick enough, the person can die from respiratory arrest.

Diagnosis of Guillain-Barre Syndrome is not always easy because symptoms can be different from person to person. The symptoms can be the same as those of other brain and nerve disorders, therefore, during an exam, a doctor will carefully review the patient's medical history and perform a reflex test known as the knee-jerk test. Blood tests are performed as well as an EMG, or Electromyography, and a Lumbar Puncture.

During an EMG, a needle electrode is inserted through the skin and into the muscles. The electrode will give an electrical recording of the muscle activity and determine whether or not the muscles react when specific nerves are stimulated. The nerves are stimulated through a small electrical shock to determine how well the muscles respond and how quickly the nerves themselves respond to stimulation. In Guillain-Barre Syndrome, nerve damage causes the muscles to be unresponsive.

During a Lumbar Puncture, a needle is inserted into the spinal canal to help determine the pressure of the spinal fluid. During this test, a patient is under a local anesthesia to numb the area of the lower back where the needle is inserted. A sample of the spinal fluid is also taken to be tested for bleeding in the brain and spinal cord along with the presence of any bacteria or fungi that may be causing the problems.

When someone is diagnosed with Guillain-Barre Syndrome, they are normally hospitalized so that doctors can keep a close eye on the progression of their symptoms. It is common for a person with Guillian-Barre Syndrome to be monitored in an Intensive Care Unit because the way the disorder progresses is very unpredictable. Doctors and nurses need to keep a close eye on the patient and closely monitor their vital signs. Often times the body needs help to function until the time when the nerves are able to do their job again.

While in the hospital, patients with Guillian-Barre Syndrome will likely undergo treatment to help them have a faster recovery. There are a couple of treatments for Guillain-Barre Syndrome; Plasmapheresis and Intravenous Immunoglobulin.

Plasmapheresis is a treatment that in essence cleans the person's blood. The plasma, or liquid portion of the blood, is removed from the actual blood cells. The blood cells are put back into the body. The body will then make more plasma to replace what has been removed. This process helps to remove the antibodies that contribute to the attack on the nerves.

Intravenous Immunoglobulin is a treatment in which healthy antibodies are put into the patient's body. The healthy antibodies come from donors. High doses of this immunoglobulin can block the harmful antibodies that contribute to the disorder.

Each treatment seems to be effective. No one treatment is better than the other and they are no more effective if they are both used.

While a person has Guillain-Barre Syndrome, it is usually necessary for a nurse or therapist to manually move the extremities and work the muscles to help prevent atrophy. Once the patient begins to recover, they often need to go through physical therapy or rehabilitation to regain strength and mobility.

Although the root cause of Guillain-Barre Syndrome is unknown, there are some things that seem to put a person at a higher risk. A young or older adult seems to be at a higher risk than a child or middle-aged adult.

There are some things that are thought to trigger the onset of Guillain-Barre Syndrome. The most common trigger seems to be any infection that includes campylobacter, which is a type of bacteria that is often found in undercooked food, especially in undercooked poultry, such as chicken. Other viruses that appear to be triggers are Epstein-Barr virus and HIV. Hodgkin's disease, mononucleosis, surgery, and sometimes the rabies or influenza immunizations.

There are some complications that can arise from Guillain-Barre Syndrome. Some of these complications are temporary and some are permanent. Difficulty in breathing can be a fatal complication. Generally, a person experiencing this complication will be put on a ventilator until they are able to breathe on their own again. Some people experience some mild, residual weakness, numbness and/or tingling. These complications seem to lessen over time as a person completely recovers from this disorder. Some people relapse and experience Guillain-Barre Syndrome all over again. Permanent complications can include problems with sensations and coordination and severe disabilities. Although rare, some people do die from complications of respiratory distress syndrome and heart attacks. The more severe the early symptoms are, the more likely it is for the person to have long-term complications.

If you experience tingling or weakness that begins in your feet and hands and is spreading quickly or spreading upward, and difficulty breathing, or choking on your own saliva, you should go to the hospital immediately. There are all early symptoms of Guillain-Barre Syndrome. The earlier it is caught and treatment is started, the better chance of the person experiencing a quick and complete recovery.

Sources for this article come from:

http://kidshealth.org
http://medicalcenter.osu.edu/patientcare/healthcare_services/nervous_system
http://www.medicalnewstoday.com
http://www.mayoclinic.com/health/guillain-barre-syndrome