Guillain-Barré syndrome (GBS) is a rare disorder of the peripheral nerve system that results in muscle weakness. Peripheral nerves travel to and from the brain. About 3500 cases are diagnosed each year in the United States and Canada. Anyone can get it, at any age, and both sexes are equally affected. There’s no cure, but about 85% of people recover completely. It cannot be prevented.
The exact cause is unknown, but more than two thirds of people have an infection 1 to 3 weeks before the muscle weakness. It isn’t contagious. Most experts believe that it’s an autoimmune disease. Autoimmune means that the body’s own immune (infection-fighting) system produces antibodies against its own nerves.
First symptoms include weakness and tingling in the legs that often spread to the arms and upper body.
These symptoms can get so bad that the muscles cannot be used at all and people are almost totally paralyzed. Then, the disorder can become life-threatening. It can interfere with breathing, blood pressure, or heart rate. Abnormal heartbeat, infections, and blood clots can also occur. It can affect breathing muscles such that some people need to be put on a ventilator.
The disorder can progress rapidly over a few hours or days or more slowly over 3 to 4 weeks. Most people have the greatest weakness in the first 2 weeks after symptoms start, so by the third week, 90% are at their weakest.
The health care provider will make a diagnosis from the medical history and physical examination. The health care provider may want tests to rule out other diseases. These tests include electromyography (EMG) to measure electrical activity of nerves and muscles, lumbar puncture (spinal tap) and analysis of spinal fluid, and breathing and blood tests. A doctor who specializes in disorders of the nervous system (neurologist) will be involved in your care.
The key to treatment is to prevent complications. Plasmapheresis and high-dose immunoglobulin therapy are also used to reduce the severity and duration of the illness. In plasmapheresis, whole blood is removed from the body, and red and white blood cells are separated from plasma (liquid portion of blood). Blood cells without plasma are then returned to the body. In high-dose immunoglobulin therapy, doctors give intravenous injections of proteins that, in small amounts, the immune system normally uses to attack organisms.
The most critical part of treatment is to keep the body working during recovery of the nervous system. Using a respirator, heart monitor, or another machine that helps the body work may be needed. Usually, people are treated in the hospital, often in the intensive care ward.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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