CONDITIONS

Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP). It is a neurological disorder in which the body’s immune system attacks the peripheral nervous system, the part of the nervous system outside the brain and spinal cord. The onset of GBS can be quite sudden and unexpected and requires immediate hospitalization. It can develop over a few days, or it may take up to several weeks with the greatest weakness occurring within the first couple of weeks after symptoms appear.

GBS is rare. It can affect people at any age and both men and women equally. GBS often develops after a respiratory or gastrointestinal viral infection.

Causes

It’s not clear why some people get GBS. What is known is that the body’s immune system begins to attack the body itself.

Normally, the cells of the immune system attack only foreign material and invading organisms, but in GBS, the immune system starts to destroy the myelin sheath that surrounds the axons of many nerve cells, and, sometimes, the axons themselves.

When this occurs, the nerves can’t send signals efficiently, the muscles lose their ability to respond to the commands of the brain, and the brain receives fewer sensory signals from the rest of the body. The result is an inability to feel heat, pain, and other sensations.

GBS can occur after a viral infection, surgery, injury, or a reaction to an immunization.

Symptoms

These are the most common symptoms of GBS. But each person may have slightly different symptoms.

The first symptom includes weakness or tingling sensations in the legs. This sometimes spreads to the arms and upper body. A neurological exam usually reveals a loss of all deep tendon reflexes. The symptoms may get worse. In some cases, you may not be able to use your muscles at all. You become paralyzed, and breathing is hard. Your blood pressure and heart function are affected. GBS is a medical emergency and needs to be treated promptly.

Although symptoms can become life-threatening, partial recovery is possible from even the most severe cases of GBS. But you may always have some degree of weakness.

The symptoms of GBS may look like other health conditions

• Difficulty with eye muscles and vision
• Difficulty swallowing, speaking, or chewing
• Pricking or pins and needles sensations in the hands and feet
• Pain that can be severe, particularly at night
• Coordination problems and unsteadiness
• Abnormal heart beat/rate or blood pressure
• Problems with digestion and/or bladder control.

Diagnosis

The signs and symptoms of GBS vary. It can be difficult to diagnose in its earliest stages.

These signs and symptoms are unique to GBS:

• Symptoms on both sides of the body
• Symptoms appear quickly–days or weeks instead of months
• Loss of reflexes
• High protein level in cerebral spinal fluid. This is the fluid that surrounds the spinal cord and brain.

To diagnose GBS, you may have the following tests:

• Spinal tap (lumbar puncture).A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to find out if there is an infection or other problems.
• Electrodiagnostic tests, such as electromyography (EMG) and nerve conduction velocity (NCV).These studies are done to evaluate and diagnose disorders of the muscles and motor neurons. Electrodes are inserted into the muscle, or placed on the skin overlying a muscle or muscle group, and electrical activity and muscle response are recorded.