Guillain-Barré Syndrome

(Acute Inflammatory Demyelinating Polyradiculoneuropathy; Acute Inflammatory Demyelinating Polyneuropathy; Acute Idiopathic Polyneuritis; Acute Inflammatory Polyneuropathy; Acute Autoimmune Neuropathy; Idiopathic Polyneuritis; AIDP)

Definition

Guillain-Barré syndrome is a rare condition that causes the immune system to attack the nerves outside of the brain and spinal cord. It is characterized by numbness, tingling, weakness, or paralysis in the legs, arms, breathing muscles, and face. It can affect all ages.
Nervous System
CNS and PNS
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Causes

The exact cause of Guillain-Barré syndrome is unknown. However in about 70% of people, a recent infection or surgery triggers an autoimmune response. This autoimmune response attacks the peripheral nerves, leading to weakness and a loss of sensation.

Risk Factors

Guillain-Barré syndrome is more common in men, and in the those aged 15-35 years and 60-75 years old. Other factors that increase your chance of Guillain-Barré syndrome may include:
  • Recent gastrointestinal or respiratory infection by viruses or bacteria
  • Recent vaccination—especially influenza and meningococcal
    • The swine flu vaccine given from 1976-1977 was linked to excess cases of Guillain-Barré syndrome. (Since then, influenza virus vaccines have been associated with only a marginally increased risk of Guillain-Barré syndrome.)
  • Recent surgery
  • History of lymphoma , systemic lupus erythematosus , or HIV infection

Symptoms

The first symptoms of Guillain-Barré syndrome include:
  • Pain—the lower back pain is the most common complaint
  • Progressive muscle weakness on both sides of the legs, arms, and face
  • Prickly, tingling sensations, usually in the feet or hands
  • Loss of normal reflexes
Symptoms may develop over a period of hours, days, or weeks. They will vary in severity from minimal to total paralysis including respiratory weakness. The symptoms grow progressively worse. Most people experience the greatest weakness during the second or third week. Related complications include:
  • Facial weakness
  • Blood pressure instability
  • Heart rate changes
  • Sweating abnormalities
  • Heart arrhythmias
  • Urinary/gastrointestinal dysfunction
  • Breathing difficulty
  • Death
Most people fully recover, but others may have residual symptoms, or permanent or disabling problems.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical will be done.Tests may include:

Treatment

Treatment aims to reduce the body’s autoimmune response and decrease complications that result from immobility. Hospitalization is important because symptoms may rapidly become more severe, including respiratory failure, heart arrhythmias, and blood pressure instability.Common treatments include:

Plasmapheresis

During plasmapheresis, blood is removed from your body and passed through a machine that separates blood cells. The separated cells are then returned to your body with new plasma. This procedure may help shorten the course and severity of Guillain-Barré syndrome.

High-dose Immunoglobulin Therapy

Intravenous infusion with immunoglobulin (IVIg) may help reduce the severity of a Guillain-Barré attack. Immunoglobulins are proteins that are naturally produced by the body’s immune system.

Mechanical Ventilation

In some cases, muscles necessary for breathing become paralyzed. This is treated with immediate emergency support from a mechanical ventilator.

Medications

Your doctor may advise
  • Over-the-counter or prescription pain relievers
  • Antiseizure medications

Prevention

There are no current guidelines to prevent Guillain-Barré syndrome.

RESOURCES

Guillain-Barré Syndrome Foundation International
http://www.gbs-cidp.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES

Canadian Institute for Health Information
http://www.cihi.ca

Health Canada
http://www.hc-sc.gc.ca

References

Amyotrophic lateral sclerosis. EBSCO DynaMed website. Available at: Available at: http://www.ebscohost.com/dynamed. Updated January 5, 2015. Accessed January 23, 2015.

Guillain-Barre syndrome. EBSCO DynaMed website. Available at: Available at: http://www.ebscohost.com/dynamed. Updated December 23, 2014. Accessed January 23, 2015.

Vucic S, Kiernan MC, Cornblath DR. Guilainn-Barre: an update. J Clinical Neuroscience. 2009;16(6):733-741.

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