Guillain-Barré syndrome (GBS) refers to a rare medical condition wherein immune system of a person attacks the peripheral nerves. GBS is a progressive disorder and the risk of life-threatening complications increases with time elapsed after the onset of symptoms. GBS is also known as acute inflammatory polyradiculoneuropathy, or acute idiopathic polyneuropathy. GBS causes symptoms such as weakness or tingling in your body parts, particularly in your extremities. The condition can progress to severe muscle weakness, loss of sensation or paralysis in areas such as your face, buttocks and legs. GBS affects roughly 3 out of every 100,000 people in the US every year and at least one-third of people diagnosed with GBS recover completely.
GBS is caused by antibodies that attack the myelin sheath surrounding motor neurons in your spinal cord. The myelin sheath is a protective covering that protects and insulates the axons of your motor neurons, which are responsible for transmitting signals to your muscles and glands. In GBS, exposure to an infectious agent or vaccination activates your immune system to produce antibodies against itself. This results in damage to specific locations in the central nervous system that control and coordinate muscle movement.
Symptoms of Guillain-Barré syndrome (GBS)
Signs and symptoms of GBS usually start in your arms and legs and progress to your body’s muscles, including those involved in breathing. In some cases, facial muscles may be affected and patients may experience facial weakness.
Patients experience the following symptoms:
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Muscle weakness (difficulty standing, walking, speaking)
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Numbness or tingling sensation
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Pain in the arms, legs or face
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Nausea and irritability (restless)
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Fatigue
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Malaise after a viral illness such as a respiratory tract infection, gastroenteritis or conjunctivitis.
Sudden onset of muscle weakness is usually most prominent in your lower limbs, followed by your upper limbs. Patients may also experience loss of sensation that causes pain when touched or excessive sensitivity to touch. Neuropathy is the most common initial symptom of GBS and involves a symmetrical, sensory, motor and autonomic configuration. Weakness may progress to muscle paralysis. Patients may experience difficulty swallowing, problems with breathing, stiffness and fatigue.
GBS progresses in four different stages:
1- Acute onset stage
2- Hyper-activated stage – lasts for two to three days
3- Reactive stage – lasts 10 to 14 days
4- Recovery stage – relapse typically occurs if it is not treated aggressively with IVIG and plasmapheresis.
Diagnosis of Guillain-Barré Syndrome (GBS)
GBS is diagnosed through a combination of symptoms and findings in your physical examination. Do not test positive for GBS if your doctor suspects you may have had a viral illness and that is the cause of your symptoms. There are few laboratory tests that support the diagnosis of GBS, but results may show slight elevation of certain white blood cells, including basophils and eosinophils. Elevated levels of antibodies also support the diagnosis. Your doctor may take your medical history and perform tests such as blood tests, spinal fluid analysis, nerve conduction studies and electromyography.
Treatment of Guillain-Barré Syndrome
A brief course of corticosteroids and supportive therapy (such as IVIG) is the mainstay for treating GBS. However, there is no cure for GBS
Guillain-Barré syndrome (GBS) affects your body’s ability to communicate with your limbs and you may take several weeks or months to recover from it. Patients should be referred to a specialist who can determine what treatment plan is best for them, depending on their medical background and the severity of their symptoms.
Guillain-Barré syndrome (GBS) is a treatable condition that can be managed with medications and rehabilitation. Most patients undergo an intravenous immunoglobulin (IVIG) infusion. The treatment for GBS should be started as early as possible after the onset of symptoms to improve your chances of a full recovery. Patients who regain muscle strength have the opportunity to resume their normal life activities after being discharged from the hospital.
During the acute phase of GBS, treatment involves supportive measures and therapies that reduce the severity of your symptoms. This involves pain medications, IV fluids, antibiotics, and intravenous immunoglobulin (IVIG).
Conclusion
GBS is a rare disorder that occurs in men and women equally, with one to two cases per 100,000 people each year. GBS can develop at any age and affects both sexes equally. There is no way to predict who will be affected by GBS. However, more women than men are diagnosed with GBS at a ratio of 3:2. The median age of onset is between 50–60 years and the incidence peaks between 60–70 years of age, approximately 1 episode per 1000 person-years.