Guillain-Barre syndrome is a rare but serious disorder in which the cells of your immune system attack healthy nerve cells of your peripheral nervous system. This can lead to numbness, weakness, and even paralysis of the affected regions. In majority of the cases, symptoms begin to appear on the hands and feet, but they can spread throughout your whole body. The causative factors of this disease are unknown, but it has been noticed that it gets triggered by an infection. There is no cure available for Guillain-Barre syndrome, but several management options can help reduce the severity of this disease.
The exact cause of Guillain-Barre syndrome has not been determined yet. It is considered an autoimmune disease in which the cells of your immune system recognize your nerve cells as harmful and attack them. Most people with this syndrome report a preceding infection in the last six weeks before the symptoms appear. It can be triggered by a respiratory or digestive tract infection. Some cases have been reported after being infected with Zika virus, COVID 19 virus, or Campylobacter jejuni. In rare cases, it can also be triggered by a recent vaccination or surgery.
There are several types of Guillain-Barre syndrome, but the most common types are the following:
Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) is the most common type found in North America and Europe. The initial symptom of AIDP is muscle weakness that begins in the lower body and then continues to spread upwards.
Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-sensory Axonal Neuropathy (AMSAN) are less common in the United States and more common among Chinese and Japanese people. Both of these diseases cause axonal degeneration.
Miller Fisher syndrome (MFS) is also less common in the United States. It is found more often among the Asian population. Paralysis begins in the eyes and then spreads to other regions of the body.
People of any age group can be affected by Guillain-Barre syndrome, but the risk increases with increasing age. Since various organisms can trigger the diseases, your risk is higher if you had a recent infection, trauma, vaccination, or surgery. Organisms most often noticed with Guillain-Barre syndrome include Campylobacter jejuni, Zika virus, COVID 19 virus, Hep A, B, C, and E virus, Epstein-Barr virus, cytomegalovirus, and HIV.
The incidence of Guillain-Barre syndrome varies from 0.4 to 4.0 individuals out of 100,000 people. It is slightly more common among males than females. There is no racial predilection associated with this disease.
The initial signs and symptoms of Guillain-Barre syndrome usually begin to develop in the lower body. You may feel a tingling sensation in your feet or legs, progressing upwards. Some people may notice the symptoms in their arms or face first. As the condition progresses, you will feel weakness in your limbs and may have an unsteady gait. You may also experience other symptoms such as difficulty speaking, chewing and swallowing, double vision, difficulty moving eyes, bladder control issues, severe pain that may worsen at night, rapid heartbeat, changes in blood pressure, and breathing issues. Muscle weakness can slowly progress to paralysis in severe cases.
A thorough history is required before proceeding with diagnostic tests. If you had a recent bacterial or viral infection, mention it to your healthcare provider. Your doctor can also perform a physical exam to evaluate your muscle strength and reflexes. The first diagnostic test is a spinal tap or lumbar puncture in which a small sample of your cerebrospinal fluid is taken. People with Guillain-Barre syndrome have a higher concentration of protein in CSF. Electromyography and nerve conduction velocity tests are also done to see your nerve and muscle activity in response to electrical signals.
Guillain-Barre syndrome is difficult to diagnose because its symptoms can mimic with the symptoms of many other neurological diseases. Some common conditions include botulism, meningitis, heavy metal poisoning, acute flaccid myelitis, electrolyte disturbance, myasthenia gravis, Eaton-Lambert syndrome, stroke, and poliomyelitis.
Since Guillain-Barre syndrome is an autoimmune disease, its symptoms may get better on their own over time. There is no known cure available for this disease, but it can be managed using different strategies. You will likely be admitted to a hospital where your progress is monitored until you are better enough to be discharged. Two techniques that can help slow down this disease’s progress are plasmapheresis and immunoglobulin therapy. In plasmapheresis, your blood is drawn, and plasma is separated from your blood cells. The blood cells then produce new plasma to replace the lost one. This may reduce antibodies in the blood. Immunoglobulin therapy is performed by injecting healthy antibodies from blood donors into the patient. These antibodies can block the effect of the antibodies that attack your nerve cells.
Apart from these treatment options, you will need medications for symptomatic relief and physiotherapy to improve the movement of your arms and legs.
Your doctor can prescribe suitable analgesics to reduce pain episodes. Weakness or numbness in the legs or arms cannot be reduced by medication and should be improved with physiotherapy.
Almost 80% of adults can walk independently after six months of being diagnosed with Guillain-Barre syndrome. It can take around 1 year to regain most of your motor functions. Only 5 to 10% of people may have a delayed or incomplete recovery.
There are no known strategies to prevent Guillain-Barre syndrome. In case you develop weakness in your legs or arms a few weeks after a viral or bacterial infection, contact your doctor for a better diagnosis and early intervention.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 20, 2023.
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Guillain-Barré syndrome - ScienceDirect