Guillain-Barre syndrome (GBS) is a serious disorder that occurs when the body’s defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness. It is the most frequent acquired (as opposed to inherited) neuropathy. Nobody knows why or how GBS infects certain individuals and not others. Its cause is unknown, but it is triggered by a viral or bacterial infection in most patients that somehow causes an autoimmune reaction, i.e. your own immune system attacks your body. As it is generally seen after an infection, it is called a ‘post infectious autoimmune disease’. The syndrome may occur at any age, but is most common in people of both sexes between ages 30 and 50.
The disorder is characterized by progressive symmetrical paralysis and loss of reflexes, usually beginning in the legs. This means that in mild cases, the attack on the nerves may stop, going no further. The patient may experience only moderate difficulty in walking, requiring a walking stick or crutches. In other cases, the progressing attack gives rise to symptoms of increasing severity. In extreme cases, weakness may have progressed to the extent that the patient is almost totally paralyzed. This may cause difficulty breathing, and the patient needs to be immediately hooked to a ventilator that assists breathing. If the muscles of the heart are affected, the patient will experience irregular heartbeat. He or she needs to be hooked to a cardiac monitor immediately. If the swallowing mechanism is affected, a feeding tube may be required.
Typical symptoms include loss of reflexes in the arms and legs, muscle weakness or loss of muscle function (paralysis), numbness or a decreased sensation, sensation changes, tenderness or muscle pain (may be a cramp-like pain) and uncoordinated movement. Additional symptoms might be blurred vision, clumsiness and falling, difficulty moving face muscles, muscle contractions and palpitations (sensation of feeling the heartbeat). Emergency symptoms would be breathing that temporarily stops, not being able to take a deep breath, difficulty breathing, difficulty swallowing, drooling, fainting and/or a light-headed feeling when standing. A history of increasing muscle weakness and paralysis may be a sign of Guillain-Barre syndrome, especially if there was a recent illness.
There is no cure for Guillain-Barre syndrome. However, many treatments are available to help reduce symptoms, treat complications and speed up recovery. When symptoms are severe, the patient will need to go to the hospital for breathing help, treatment and physical therapy. Other treatments are directed at preventing complications. Blood thinners may be used to prevent blood clots. If the diaphragm is week, breathing support or even a breathing tube and ventilator may be needed. Pain is treated aggressively with anti-inflammatory medicines and narcotics. Proper body positioning or a feeding tube could be used to prevent choking during feeding if the muscles for swallowing are weak. Recovery can take weeks or years. Most people survive and recover completely. According to the National Institute of Neurological Disorders and Stroke, about 30% of patients still have some weakness after 3 years. Mild weakness may persist for some people. A patient’s outcome is most likely to be very good when the symptoms go away within 3 weeks after they first started.