What is Guillain-Barre Syndrome?

Guillain-Barre Syndrome (GBS) is a rare and life-threatening autoimmune condition in which the immune system paralyzes the body's own peripheral nerves. The interference might lead to weakness of muscles, numbness, walking trouble, and paralysis in extreme cases.

While anyone of any age can get GBS, it happens a bit more often in men and adults. While frightening, the earlier you are diagnosed and treated, the better your chances for complete recovery. During this period, we will be explaining symptoms, treatments, and etiologies of GBS in lay terms so that you will have a better idea about this complicated illness.

Understanding Guillain-Barre Syndrome (GBS)

Guillain-Barre Syndrome is a disease of the peripheral nervous system, the brain, spinal cord, and rest of the body's nervous system. When nerves become inflamed or injured, the line of communication is broken, and weakness or loss of function follows.

GBS will begin with weakness or numbness of the legs and feet. This is then followed by weakness and numbness of the arms and chest. In others, however, GBS rapidly turns into an acute phase that requires immediate care. Although dangerous, the majority of the patients fully recover from GBS with some residual sequelae such as weakening or fatigue.

Symptoms of Guillain-Barre Syndrome

Early detection of the symptoms and signs of GBS such that the patient is treated promptly. Symptoms and signs usually take hours or days, but weeks in some patients.
Signs are:

  • Fingering or "pins and needles" in fingers, toes, ankles, or wrists.
  • Weakness in muscles starting from the lower extremities and going up.
  • Stumbling gait or walk or weakness on the ability to climb stairs.
  • Trouble with facial movement, such as speaking, chewing, or swallowing.
  • Diplopia or eye movement difficulty.
  • Severe pain, generally at night, and generally aching or cramping in character.
  • Bladder or bowel dysfunction.
  • Racing heart rate or alteration in blood pressure.
  • Shortness of breath, at times requiring ventilator support.
Symptoms usually peak two to four weeks after the onset of symptoms. Hospitalization is not uncommon in an effort to closely observe breathing and heart.

Causes of Guillain-Barre Syndrome

The cause of GBS is not known but in the vast majority of cases secondary to infection as a trigger for symptoms. The body's immune system, in the vast majority of cases, mistakenly identifies the body's nervous tissue when trying to act against infection.
Confirmed Causes and Risk Factors:

  • Viral infection: influenza, Epstein-Barr virus, cytomegalovirus (CMV), Zika virus.
  • Bacterial infection: Campylobacter jejune, yet another bacterium most frequently better known to be the causative agent of food poisoning.
  • Immunizations: In some instances, GBS has been caused by immunization, e.g., the flu vaccine.
  • Surgery or trauma: Operation, particularly gastrointestinal or respiratory tract operation, has in some instances been found to be linked to GBS.
  • COVID-19 illness: New research has established that COVID-19 illness is the culprit for causing GBS in extremely rare instances.
  • Other infections: HIV and hepatitis in a few instances cause GBS.
Typically, GBS is an immunological hyper reaction of the states, where the immune system is attacking nerve cells as if they were pathogens.

Diagnosis and Medical Evaluation

GBS will become challenging to diagnose because its presentation can hardly be distinguished from that of other nervous system disorders. Nonetheless, through history taking, physical examination, and some investigations, clinicians are able to make diagnoses.
Routine diagnostic tests:

  • Spinal tap (lumbar puncture): Examines cerebrospinal fluid for the presence of raised proteins but without the associated increase in white blood cells.
  • Electromyography (EMG): Examines electrical muscle activity and may demonstrate evidence of latency of nerve impulse conduction.
  • Nerve conduction studies (NCS): Examines capacity for conduction and rate at which nerves transmit electric impulses.
  • MRI scans: Other illness, i.e., inflammation or tumors pressing on nerves.
Early treatment is essential as early intervention markedly decreases the risk of long-term complications.


Treatment of Guillain-Barre Syndrome

No cure exists, but therapy can speed recovery and prevent severity of illness. Prevention of nerve damage to the greatest extent possible, relief of symptoms, and preservation of body function during convalescence are some of the priority considerations.

Principal Modes of Treatment

  • Plasmapheresis (plasma exchange): To remove nasty antibodies from blood by sucking out plasma.
  • Intravenous immunoglobulin (IVIG): To administer large quantities of good antibodies intravenously into the circulation so the bad ones won't.
  • Pain relief: Pain medications like gabapentin or carbamazepine can be administered to enhance pain in the nerves.
  • Supportive care: For urgent respiratory support, anticoagulation to prevent blood clots, and cardiac and pulmonary monitoring.
  • Physical and occupational therapy: Enhances the mobility and independence of the patients.
  • Nutritional support: Tube feeding would be required in some of the patients with impaired swallowing for a limited time period.
Treatment is begun in most of the patients early in GBS to prevent rapid worsening of symptoms.

Recovery and Rehabilitation

There is only so much variation from patient to patient in recovery of GBS. Most will recover to baseline, but some will still have weakness, numbness, or fatigue that may last for months to years.
Variables affecting the rate of recovery are:

  • Age: The younger the patient, the faster he/she will recover.
  • Severity of the symptoms: Less severe symptoms will recover faster.
  • Speed of treatment: The sooner the treatment begins, the better.
  • General health: Good body health and immunity enable rehabilitation.

Techniques of Rehabilitation Used:

  • Physical therapy: To rehabilitate weakened muscles and coordination.
  • Occupational therapy: To rehabilitate activities of daily living and accommodate any new weakness.
  • Speech therapy: If facial or respiratory muscles are involved.
  • Psychological counseling: Psychological counseling is needed since GBS can lead to depression and anxiety.
The patients will be susceptible to needing family care and emotional support in an effort to keep the recovery process on a continued course.

Life with Guillain-Barre Syndrome

Life with GBS, or even the recovery process itself, has to be approached slowly and according to rehabilitation. Optimism and commitment to therapy processes are predictors of the recovery of independence.
Patients are susceptible to the occurrence of long-term complications of:

  • Chronic pain
  • Intact balance
  • Fatigue
  • Relapses (rarely)
Support group therapy or activity would be great emotional support and would keep individuals from being so alone to recover. Neurologist follow-up and rehabilitation staff follow-up are helpful to track recovery and to change therapy as needed.

Conclusion

Guillain-Barre Syndrome is an extremely serious but rare neurological disorder that must be diagnosed and treated early in life to achieve the optimum outcome. Although it renders the patient extremely handicapped for a brief interval of time, most of the patients can be much better if they receive proper medical care and rehabilitation.

Timely recognition of symptoms, facing potential causations, and suspicion will save a life. You or your patient are having sudden weakness or sudden numbness and are in a position to rush to the doctor directly, and possibly save a life.
Eloquent educational exclusions alone, relatives and patients are able to navigate waves of GBS and await an uneventful and triumphant recovery course.

Please book an appointment with the best Neurologist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find the verified doctor for your disease.