Guillain- Barre Syndrome (GBS) is a rare autoimmune disease affecting the nervous system of body. The disease was first described by French army neurologist in 1916. It has an incidence of 1in 100000 people. In this disease the immune system attacks the peripheral nervous system of the body leading to weakness and tingling numbness in extremities which is followed by more severe symptom of flaccid paralysis.
The exact cause of Guillain- Barre syndrome is not known, but it often develops after a viral infection. At least 50 to 60 percent cases are known to have history of a preceding viral infection like respiratory viral infection or stomach flu.Patient with severe symptoms need to be hospitalized to receive treatment. Majority of people recover from the illness although some amount of residual effect of weakness, fatigue and numbness persists for a long period of time.
Causes And Risk Factors Of Guillain-Barre Syndrome
The exact cause of Guillain- Barre syndrome is not known. However, one thing is clear that this disorder has been found to develop few days or weeks after respiratory viral illness or viral diarrhea. In this disease the immune system acts weirdly. It attacks healthy nervous system. Hence the disease is known to be an autoimmune disease.In majority of cases the myelin sheath which protects the nerves gets damaged. This damage prevents smooth message flow from peripheral nerves to brain thus leading to weakness, tingling numbness in the body parts. The peripheral nerves have to bear the brunt.
The organisms that have been associated with Guillain- Barre syndrome are campylobacter jejuni which is mainly responsible for diarrhea. Campylobacter is found commonly undercooked food and poultry products. Other infections involved with GB syndrome are viral influenza, cytomegalovirus, Epstein-Barr virus, hepatitis B and C, mumps and herpes virus.
Other conditions implicated are typhoid, filariasis, bee sting, vaccination for rabis, small pox, oral polio, and tetanus toxoid. Campylobacter jejuni is associated with severe form of Guillain- Barre syndrome. The disease usually affects males more than females. Its incidence increases with age and is highest in the 50 to 70 years age group.
Sign And Symptoms Of Guillain Barre Syndrome
Patient presents with acute onset of minor sensory symptoms such as tingling and weakness at first. These symptoms occur in feet and toes and gradually spread upwards to hands, arms and shoulder. In few patients the symptoms develop in descending order. As Guillain- Barre syndrome progresses the weakness may turn into more serious form into paralysis of limbs.
Following are the signs and symptoms of Guillain- Barre syndrome:
- Tingling and prickling sensation in toes and fingers.
- Weakness in leg muscles which gradually travel upwards leading to weakness in arm and shoulder.
- Pain in lower back is common.
- Patient finds difficulty in walking and standing.
- Difficulty in movement of eye, talking, swallowing and chewing food.
- Bladder and bowel incontinence.
- Difficulty in breathing
- Abnormal blood pressure
- Rapid heart rate
Almost 30 percent of patients have significant weakness in 7 days while in others it may progress for up to 4 weeks. Respiratory distress occurs in almost 50 percent of patients and 20 percent may require associated ventilation. Recovery begins two to four weeks after the weakness of limb muscles have reduced.
Treatment And Recovery Time For Guillain Barre Syndrome
Ideally all the patients suffering from Guillain- Barre syndrome must be hospitalized preferably in ICU care. Hospitalization is good in early stage for observation and in case of advanced stage of disease for managing respiratory paralysis. The two specific treatment modalities such as immunoglobulin therapy and plasma exchange are beneficial in reducing the severity of symptoms and for initiating faster recovery.
Immunoglobulin is given intravenously. It will counteract the antibodies that are involved in autoimmune response. Plasma exchange (plasmapheresis) is a technique that allows removal of plasma from the blood. This process helps to remove antibodies that may be attacking the healthy cells. Both the methods are found to be effective. Usually only one method is enough for recovery.
Generally Guillain- Barre syndrome after its occurrence becomes worse in first two weeks and gradually the symptoms recede. Recovery starts after 3 to 4 months and patient may start to walk without any help. It may take 6 to 12 months for the patient to recover completely, although some amount of deficit may persist for long period. During the period of recovery patient benefits from physiotherapy and counseling.