WHAT IS GUILLAIN BARRE SYNDROME?
Guillain barre syndrome (GBS) is a rare auto-immune disorder in which the immune system attacks the nerve cells of the peripheral nervous system, which is a network of cells found outside of the brain and spinal cord and its cells connect the brain and the rest of the body and aid in transmitting the right signals to the body muscles.
The body muscle will not be able to receive signals from the brain effectively when there is damage to these cells hence, resulting in weakness, numbness, and tingling, and in severe cases inability to breathe independently and paralysis.
According to the National Institute of Neurological Disorders and Stroke, Guillain barre syndrome is estimated to affected 1 in every 100,000 Americans per year. GBS affects all both young and old, male and female but has more prevalence amongst older people.
TYPES OF GUILLAIN BARRE SYNDROME:
Although Guillain Barre syndrome is a singular disorder, it occurs in several forms. They include:
- Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)
This is easily found in North America and Europe. It is characterized by muscle weakness which occurs at the lower part of the body and spreads to another part of the body especially the upper part of the body. It affects the myelin coating affecting nerve signal transmission
- Miller Fisher Syndrome (MFS)
Here, paralysis occurs in the eyes. It is mostly associated with unsteady movement. It is very common in Asia. It affects the cranial nerve causing abnormal muscle coordination resulting in clumsy gait, weakness of the eye muscles, and absence of tendon reflexes.
- Acute Motor Axonal Neuropathy (AMAN) and Acute Motor Sensory Axonal Neuropathy (AMSAN)
They are rarely found in the US but quite common in Japan, China, Mexico, etc. the axons are damaged by the autoimmune response of the immune system.
GUILLAIN BARRE SYNDROME CAUSES
The cause of Guillain barre syndrome is unknown, but most cases report incidents of infection such as respiratory or gastrointestinal infection. According to reports, two-third of people with Guillain barre begins soon after they had been sick with diarrhea or a lung infection which implies that it could be triggered by an improper immune response to a previous illness.
The incidence of developing Guillain barre is higher after the flu or an infection such as COVID-19.
- Age; although it affects all ages, its risk increases as you get older.
- It is quite common in males than females
- Influenza virus
- Zika virus
- Mycoplasma pneumonia
- Surgery complications
- Hepatitis A, B, C, and E
- Epstein-Barr virus
- Campylobacter is found in undercooked poultry.
GUILLAIN BARRE SYNDROME SYMPTOMS
Symptoms are usually progressive and they include:
- Tingling sensation in the toes and legs
- Muscle weakness in the legs that travels to the upper body with time.
- Difficulty when walking
- Difficulty when moving your eyes or face
- Double vision
- Difficulty in talking, chewing, and swallowing
- Severe lower back pain which gets worse at night
- Difficulty with bladder control
- Increase in heart rate
- Difficulty in breathing
DIAGNOSIS OF GUILLAIN BARRE SYNDROME
Since symptoms are quite similar to other neurological disorders or conditions such as botulism, meningitis, or heavy metal poisoning which could be caused by lead, mercury, and arsenic, therefore it is difficult to diagnose Guillain-barre at first.
However, when suspicious symptoms arise, the following diagnostic test can be used:
- Spinal Tap
This procedure involves the puncture of the lower back to take a small amount of fluid from the spine, which is then tested to check protein level. This fluid is called cerebrospinal fluid. In Guillain-barre, the protein level is higher than normal in the cerebrospinal fluid. This is usually done 10days after symptoms become visible.
This is a nerve function test. It works using electrical activity from your muscle to check your muscle weakness if it is caused by nerve damage or muscle damage.
- You will be examined for recent symmetric weakness within days to 4 weeks that started at the leg.
- You will be checked for recent viral infection, absent or diminished deep tendon reflexes in weak limbs.
GUILLAIN BARRE SYNDROME TREATMENT
Since it is an auto-inflammatory process, it may resolve on its own. However, there is still a need for close observation in the hospital as symptoms can quickly worsen and become fatal.
The treatment is made to reduce the severity of the immune attack and improve body function such as lung function while helping the nervous system recover.
This treatment includes:
- Plasma Exchange (also called plasmapheresis).
In Guillain barre, the immune system produces antibodies that attack the nerves of the nervous system mistaking them as harmful foreign substances to the body.
Plasmapheresis aims to remove such antibodies produced from the blood. This process involves the removal of blood from your body by a machine that removes the antibodies from the blood removed and then returns the blood to your body.
- Intravenous Immunoglobulin
This is administered in high doses to help block the antibodies causing Guillain-barre. The immunoglobulin has normal antibodies usually gotten from a donor.
- Medications such as pain release may be given. Sometimes medications to prevent blood clotting will be given while you are immobile.
- Physical and occupational therapy will be carried out. Mostly done in severe cases. This involves the manual movement of your arms and legs.
- The breathing rate is closely monitored as respiratory failure may occur. This is carried out with the aid of a ventilator.
The complications involve with Guillain barre syndrome includes:
- Difficulty when breathing; The muscles that help in breathing may become weak or paralyzed. Approximately 22% of people with Guillain-barre syndrome will need aid from a machine so they can breathe especially within the first week of treatment.
- They may still be a lingering feeling of weakness or numbness.
- Heart pressure problems; Heart and blood pressure fluctuations are common complications of Guillain-barre syndrome.
- Pains; Severe nerve pain may be experienced even after recovery.
- Development of blood clot, which is due to immobility. Taking blood thinners may be advised by your doctor.
- Development of pressure sores.
- Sluggish bowel and bladder functions.
GUILLAIN BARRE SYNDROME PROGNOSIS
Approximately 2-5% of people with Guillain barre syndrome experience a relapse. However, few deaths have been recorded from complications such as respiratory distress syndrome. It has a high recovery rate even in severe cases and a mortality rate of 4% to 7%.
- How long does Guillain Barre last?
Guillain barre syndrome tends to worsen within two weeks after its onset but gets worst after 4weeks without treatment. However, when treated properly, recovery may take 12months or three years depending on how severe the condition was.
- Can Guillain barre syndrome affect the brain?
Guillain barre syndrome affects the peripheral nervous system. The peripheral nervous system consists of nerve cells except for the brain and spinal cord.
- Does Guillain barre show on MRI?
Although not frequently used, it shows affected areas of the peripherical nervous system as thickened and marked enhancement.
- Can Guillain syndrome cause neuropathy?
Since Guillain barre syndrome is an autoimmune disorder it is possible for the incidence of neuropathy to occur as the axon in the motor nerve is affected.
- What triggers Guillain syndrome?
Guillain barre syndrome could be triggered by infections such as viral infections, surgery, gastrointestinal infections, or lung infections. In rare cases, vaccinations.