GUILLAIN-BARRE SYNDROME
MUHAMMAD SULEMAN RAZA
2015-028
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May. 16
GUILLAIN-BARRE SYNDROME
Definition
Guillain-Barre (ghee-YA-buh-RAY) syndrome is a disorder in which your body's immune system attacks
your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations
can quickly spread, eventually paralyzing your whole body. In its most severe form, Guillain-Barre
syndrome is a medical emergency requiring hospitalization.
The exact cause of Guillain-Barre syndrome is unknown, but it is often preceded by an infectious illness
such as a respiratory infection or the stomach flu. Luckily, Guillain-Barre syndrome is uncommon,
affecting only 1 or 2 people per 100,000.
There's no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and
reduce the duration of the illness. Most people recover from Guillain-Barre syndrome, though some may
experience lingering effects from it, such as weakness, numbness or fatigue.
Symptoms
Guillain-Barre syndrome often begins with tingling and weakness starting in your feet and legs and
spreading to your upper body and arms. These symptoms may begin — often not causing much notice —
in your fingers and toes. In some people, symptoms begin in the arms or even the face. As the disorder
progresses, muscle weakness can evolve into paralysis.
Signs and symptoms of Guillain-Barre syndrome may include:

Prickling, "pins and needles" sensations in your fingers, toes or both

Weakness or tingling sensations in your legs that spread to your upper body

Unsteady walking or inability to walk

Difficulty with eye movement, facial movement, speaking, chewing or swallowing

Severe pain in your lower back

Difficulty with bladder control or intestinal functions

Rapid heart rate

Low or high blood pressure
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Difficulty breathing
Most people with Guillain-Barre syndrome experience their most significant weakness within four weeks
after symptoms begin. In some cases, signs and symptoms may progress very rapidly, with complete
paralysis of legs, arms and breathing muscles over the course of a few hours.
Causes
The exact cause of Guillain-Barre syndrome is unknown. In about 60 percent of cases, an infection
affecting either the lungs or the digestive tract precedes the disorder. Recent surgery, immunization and
pregnancy have also been associated with Guillain-Barre syndrome. But scientists don't know why such
an infection can lead to Guillain-Barre syndrome for some people and not for others. Many cases appear
to occur without any triggers.
In Guillain-Barre syndrome, your immune system — which usually attacks only foreign material and
invading organisms — begins attacking the nerves that carry signals to your brain. In the most common
form of Guillain-Barre syndrome in North America, the nerves' protective covering (myelin sheath) is
damaged, and this interferes with the signaling process, causing weakness, numbness or paralysis.
Risk factors
Guillain-Barre syndrome can affect all age groups, but you're at greater risk if:

You're a young adult

You're an older adult
Guillain-Barre syndrome may be triggered by:

Most commonly, infection with campylobacter, a type of bacteria often found in undercooked food,
especially poultry

Mycoplasma pneumonia

Surgery

Epstein-Barr virus
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
Influenza virus

Hodgkin's disease

Mononucleosis

HIV, the virus that causes AIDS

Rarely, rabies or influenza immunizations
Complications
Guillain-Barre syndrome affects your nerves and may prompt a domino-like effect on other systems in
your body, such as your breathing and cardiovascular functions, among others. Complications of GuillainBarre syndrome include:

Breathing difficulties. A potentially deadly complication of Guillain-Barre syndrome is that the weakness
or paralysis can spread to the muscles that control your breathing. You may need temporary help from a
machine to breathe when you're hospitalized for treatment.

Residual numbness or other sensations. Most people with Guillain-Barre syndrome recover completely
or have only minor, residual weakness or abnormal sensations, such as numbness or tingling. However,
full recovery may be slow, often taking a year or longer, with between 20 and 30 percent of people having
an incomplete recovery.

Cardiovascular problems. Blood pressure fluctuations and cardiac arrhythmias are common side effects
of Guillain-Barre syndrome, often requiring pulse and blood pressure monitoring.

Pain. Up to half of people with Guillain-Barre syndrome experience neuropathic pain, which may be
relieved by nonprescription or prescription painkillers.

Bowel and bladder function problems. Sluggish bowel function and urine retention may result from
Guillain-Barre syndrome.

Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of developing blood
clots. Until you're able to walk independently, taking blood thinners and wearing support stockings may be
recommended.

Pressure sores. Being immobile also puts you at risk of developing pressure sores, or bedsores.
Frequent repositioning may help avoid this problem.
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Relapse. Up to 10 percent of people with Guillain-Barre syndrome experience a relapse.
Severe, early symptoms of Guillain-Barre syndrome significantly increase the risk of serious long-term
complications. Rarely, death may occur from complications such as respiratory distress syndrome and
heart attack.
Tests and diagnosis
Guillain-Barre syndrome can be difficult to diagnose in its earliest stages. Its signs and symptoms are
similar to those of other neurological disorders and may vary from person to person.
The first step in diagnosing Guillain-Barre syndrome is for your doctor to take a careful medical history to
fully understand the cluster of signs and symptoms you're experiencing.
A spinal tap (lumbar puncture) and nerve function tests are commonly used to help confirm a diagnosis of
Guillain-Barre syndrome.
Spinal tap (lumbar puncture)
This procedure involves withdrawing a small amount of fluid from your spinal canal at your low back
(lumbar) level. This cerebrospinal fluid is then tested for a specific type of change that commonly occurs
in people who have Guillain-Barre syndrome.
Nerve function tests
Your doctor may want information from two types of nerve function tests — electromyography and nerve
conduction velocity:

Electromyography reads electrical activity in your muscles to determine if your weakness is caused by
muscle damage or nerve damage.

Nerve conduction studies assess how your nerves and muscles respond to small electrical stimuli.
Treatments and drugs
Although some people can take months and even years to recover, most cases of Guillain-Barre
syndrome follow this general timeline:
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
Following the first symptoms, the condition tends to progressively worsen for about two weeks.

Symptoms reach a plateau within four weeks.

Recovery begins, usually lasting six to 12 months, though for some people it could take as long as three
years.
There's no cure for Guillain-Barre syndrome. But two types of treatments may speed recovery and reduce
the severity of Guillain-Barre syndrome:

Plasmapheresis. This treatment — also known as plasma exchange — is a type of "blood cleansing."
Plasmapheresis consists of removing the liquid portion of your blood (plasma) and separating it from the
actual blood cells. The blood cells are then put back into your body, which manufactures more plasma to
make up for what was removed. It's not clear why this treatment works, but scientists believe that
plasmapheresis rids plasma of certain antibodies that contribute to the immune system attack on the
peripheral nerves.

Intravenous immunoglobulin. Immunoglobulin contains healthy antibodies from blood donors. High
doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre
syndrome.
These treatments are equally effective. Mixing the treatments or administering one after the other is no
more effective than using either method alone.
Often, before recovery begins, caregivers may need to manually move your arms and legs to help keep
your muscles flexible and strong. After recovery has begun, you'll likely need physical therapy to help
regain strength and proper movement so that you'll be able to function on your own. You may need
training with adaptive devices, such as a wheelchair or braces, to give you mobility and self-care skills.
Reference
http://www.mayoclinic.com/health/guillain-barre-syndrome/DS00413.
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