Guillain-Barre Syndrome

 

What is Guillain-Barré Syndrome?

Guillain-Barré (Ghee’-yan Bah-ray’) syndrome (GBS) is an inflammatory disorder of the peripheral nerves outside the brain and spinal cord. It’s also called Acute Inflammatory Demyelinating Polyneuropathy (AIDP) and affects 1 out of every 100,000 people. GBS is characterized by the rapid onset of numbness, weakness, and often paralysis of the legs, arms, breathing muscles, and face. Paralysis is often ascending, meaning that it travels up the limbs from fingers and toes towards the torso. Loss of reflexes or diminished reflexes are a characteristic feature. Other symptoms may include numbness, tingling, and pain in the arms and legs. The cause is unknown, but GBS is thought to be an autoimmune condition. About 50% of cases occur shortly after a microbial infection (viral or bacterial), some as simple and common as the flu or food poisoning.  GBS symptoms may worsen to the point of complete paralysis and will then gradually improve over the next several weeks. Severe cases may take longer to recover and residual symptoms of weakness and sensory loss can occur In severe cases, GBS symptoms can affect a patient's ability to breathe on their own, requiring monitoring in the intensive care unit (ICU) and possibly a ventilator.

How is Guillain-Barré Syndrome diagnosed?

To diagnosis GBS, doctors will take a perform a thorough clinical exam and obtain a detailed history of symptom onset and associated symptoms. Tests, such as a lumbar puncture or electrodiagnostic tests can help confirm a GBS diagnosis. 

How is Guillain-Barré Syndrome Treated?

Plasma exchange (a blood “cleansing” procedure) and high dose intravenous immune globulins are often helpful to shorten the course of GBS. The natural history of GBS is a peak of symptoms approximately at 4 weeks from symptom onset with no progression of symptoms beyond 8 weeks. Patient care involves the coordinated efforts of a team such as a neurologist, physiatrist (rehabilitation physician), internist, family physician, physical therapist, occupational therapist, social worker, nurse, and psychologist or psychiatrist. Some patients require speech therapy if speech muscles have been affected.

Video - https://youtu.be/4omfTbiB0kk

The GBS CIDP Foundation International has publications for patients and their caregivers related to CIDP including:

• An of Overview for the Layperson
• Guidelines for Physical and Occupational Therapy
• A Handbook for Caregivers
• Caring For A Child with GBS or CIDP 

In addition, the GBS CIDP Foundation International provides information about chapter meetings and connecting to local liaisons for support.

See also the AANEM endorsed AAN Guideline on IVIg in Neuromuscular Disorders

More Information

American Chronic Pain Association
National Institute of Neurological Disorders and Stroke
Neurology Forum
American Autoimmune Related Diseases Association, Inc 
Chronic Inflammatory Demyelinating Polyneuropathy Page