Peripheral Neuropathies: Guillain-Barre Syndrome

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rebuild myelin sheath

Guillain-Barre Syndrome is a devastating neurological disorder that causes immense pain and disability.

Guillain-Barre Syndrome, also referred to as GBS, is a severe auto-immune disorder in which the body mistakenly attacks its own nervous system. While the cause of GBS is unknown, it is believed that a common trigger exists following surgery or illness. It attacks the myelin sheath, a fatty layer surrounding the nerves, which is similar to the plastic sheath that encases a wire. Demyelination may lead to a host of problems affecting the way nerves deliver signals to the brain and spinal cord. The signals slow down or stop entirely, causing paralysis of multiple parts of the body and incredible weakness and pain.

Onset and Symptoms

Most of the GBS horror stories begin the same way: A very quick onset of the condition can lead to paralysis in as little as a few days. It usually strikes without warning and develops quickly. The condition is fairly rare, so many hospitals are not fully equipped to give a proper diagnosis. Sufferers are often sent home initially with a diagnosis of acute pain¬Ě or idiopathic neuropathy¬Ě or are referred to a neurologist for further investigation. It is important for a patient who knows something is wrong to be persistent about not being sent home and to request additional testing.

Diagram of the nerve and the myelin sheath. In GBS, the myelin sheath begins to degrade, slowing signals from the nerve to the brain and spinal cord.

Symptoms could include:

  • Tingling or numbness in the fingers and toes
  • Muscle pain
  • Loss of reflexes
  • Low blood pressure
  • Weakness or Paralysis of partial or full body, or difficulty walking
  • Blurred vision
  • Muscle contractions
  • Respiratory difficulty, or failure caused by paralysis
  • Cardiovascular irregularity or dysfunction
  • Difficulty swallowing and eating
  • Fainting
  • Drooling

Diagnosis and Treatment

A GBS diagnosis can usually be confirmed within a number of tests. An ECG, EMG, and nerve conduction velocity test are typically ordered to test muscle, nerve, and brain function. After these tests, if the doctor is still suspicious, a spinal tap might be administered to confirm diagnosis.

If GBS is confirmed, treatment will begin immediately. Artificial breathing support may be administered, and in the event of weakness to the muscles of the throat and chest, a feeding tube may be necessary. There are also treatments that block the anti-bodies that attack the nerve cells. Plasmapheresis is a method that removes the blood from the body, separates the white and red blood cells, and returns the anti-body-free blood cells back into the body. If this method doesn’t produce the desired results, doctors may try IVIG, or Immunoglobulin Therapy, a process that adds immunoglobulins to the blood in large-quantities, to aide in blocking anti-bodies. Blood-thinners, anti-inflammatories, and narcotics may also be used to treat GBS, as well.

Following these treatments, patients may need to participate in physical therapy. It is common for the disorder to disable the victim to the point that they might need to regain the ability to walk, or even something as elementary as relearning how to pick up a spoon. The recovery process can take months or years, but in most cases, patients recover completely. While there is a likelihood that symptoms can be chronic and recurring, such symptoms are usually only minor neurological conditions, blood disorders, or weakness; much milder than paralysis or organ failure.

It is possible, however, to develop more permanent symptoms if treatments are not administered immediately or are not aggressive enough. While such cases are rare, they are possible and should be considered.

Possible Complications

  • Pnuemonia or other respiratory conditions
  • Blood clots
  • Skin ulcers or damage
  • Infections
  • Permanent paralysis
  • Heart conditions

It should also be considered that unrelated ailments can become prevalent as a result of symptoms in their most severe state. Reports exist of GBS leading to respiratory failure, causing brain damage and epilepsy in some patients. Since the immune system is weak following treatment, there is also an increased risk for the development of other auto-immune disorders and viral infections. And, if joints become damaged, some patients may even develop irreparable, physical deformities.

Outlook

One must always seek medical attention immediately if they notice any significant changes in balance, coordination, or the ability to walk and/or move head and limbs, or if they experience pain, tingling, or numbness in the extremities. The earlier GBS is caught, the milder the symptoms, the quicker the recovery, and the greater the chance of a full recovery. Relapses are extremely rare, present in less than 10 percent of all cases. GBS is not genetic or contagious, although the exact origins and causes are unknown. GBS survivors recover with the ability to live happy and productive lives and without lingering complications that are severe enough to prevent working or raising a family.

Many support groups exist to help sufferers manage the disease and to offer a wide-range of resources and emotional support. For more information about Guillain-Barre Syndrome, research, and support, visit the Guillain-Barre Syndrome Foundation International at gbs-cidp.org.

 

Written By: Jenna McClure
Sources: gbs-cidp.org, NCBI
Photo credits: Cayman Chem, Huskona Hijod at Flickr

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