Guillain-Barre Syndrome (GBS)

Guillain-Barre Syndrome (GBS) is a rare disorder that negatively impacts the body’s nerves which can lead to muscle weakness, loss of movement and in extreme cases; paralysis. This rare disorder is most common in older people (50+) with reports from the CDC suggesting that in the US, only about 3000-6000 people are diagnosed per year.

Image Credit: UCL News

Overview

Guillain-Barre Syndrome(GBS) is a rare disorder that causes the human body’s immune system to damage nerves. This may result in muscle weakness and in some cases, paralysis. GBS is usually acquired through a viral or bacterial infection, but can also be contracted from diarrhea, respiratory illnesses and vaccines. Due to its rarity, not much is known about Guillain-Barre Syndrome. An investigation by the CDC found that in the United States, only 3000 to 6000 developed this disorder each year, most of those people being aged 50+. Most people recover from the disorder but some may suffer permanent nerve damage.

Causes

There are a few factors that could lead to Guillain-Barre Syndrome which includes: diarrhea, respiratory illnesses, viral and bacterial infections, and vaccinations. Diarrhea and respiratory illnesses have led to the most cases of GBS. Before getting diagnosed with the syndrome, two thirds of people reported having diarrhea or respiratory illness before. Viral infections, such as the flu and cytomegalovirus, and bacterias such as Campylobacter(due to undercooked food) have also been linked to Guillain-Barre Syndrome. Finally, vaccines have also been connected to causing GBS. Some people have reported being diagnosed with the disorder days or weeks after getting a vaccine. However, experts have concluded that vaccines have a much lower chance of causing Guillain-Barre Syndrome than other factors, and the risk of getting a vaccine is far less than not receiving one.

Symptoms

Early symptoms of Guillain-Barre Syndrome include:

Feelings of weakness and tingling(the first place being the legs, may also occur in the upper body, such as the arms)

Following these early symptoms, GBS usually progresses quite quickly and can worsen in the matter of hours.

Symptoms of Guillain-Barre Syndrome after the initial symptoms include:

Weakness of the body(worsens)
Changes to sensation(due to nerve damage; includes spontaneous sensations, tingling and muscle pain)

Other reported symptoms include:

Difficulty with vision
Difficulty swallowing, speaking and/or eating
Weak balance and coordination
Abnormal heart rate and blood pressure
Issues with digestion
Difficulty with bladder control

Diagnosis

The symptoms demonstrated by various patients differ from each other according to the stage of the syndrome they are in and their health prior. Diagnosing Guillain-Barre Syndrome during the early stages is especially difficult for physicians due to the rarity of the disease. Doctors will perform several exams to determine whether a GBS is necessary.

This includes:

Physical exam: The doctor will look at the overall state of your physical health. They will ask about medical history, look at how your muscles and nerves are functioning and your reflexes.
Nerve conduction velocity test (NCV): This test serves to see how well a nerve can send out a signal. If the signaling is slower than normal, it may be a sign of GBS.
Cerebrospinal fluid analysis: The cerebrospinal fluid of patients with Guillain-Barre Syndrome contains more proteins but less immune cells than those of a normal patient. Doctors will use a sample cerebrospinal fluid to help diagnose patients by measuring the amount of white blood cells.

Treatment

Unfortunately, there is yet to be a cure for GBS (most likely due to its rarity). There are several forms of therapy that can help with the severity of the syndrome and shorten the time needed to recover naturally. There are also many different ways to treat the disease. Patients with Guillain-Barre Syndrome are likely to be admitted into the Intensive Care Unit due to muscle weakness that could cause difficulty breathing and paralysis. Currently, there are 2 main ways of treating GBS, which are both equally as effective if administered early(within the first 2 weeks of the disease).

Acute Care

The first method for acute care is plasma exchange. This is when the blood cells in the plasma are transported out of the body and treated, and then administered back into the body. Plasma exchange works because it may be taking out the antibodies that were attacking the nerves and causing damage to them.
Another method is Intravenous immunoglobulin therapy (IVIg). This is when immunoglobulins are injected into the body which can help lessen the attacks on the nerves which in turn reduces recovery time. It is also believed that immunoglobulin therapy can also reduce the effectiveness of the antibodies that are attacking the nerves, diluting them so that the damage caused is lessened.

Rehabilitative Care

After the GBS slowly gets better, some patients may require rehabilitative care due to the nerve damage caused by the syndrome. This includes physical therapy to prevent muscle shortening, or blood thinners to prevent clotting. The main goal of these methods is to prevent the accumulation of red blood cells in veins. Additionally, physical therapy can also help with regaining proper movement after the syndrome has weakened muscles.

Sources

Guillain-Barré Syndrome and Vaccines. (2023, February 6). Center of Disease Control and Prevention.

Retrieved June 28, 2023, from https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html#:~:text=Guillain%2DBarr%C3%A9%20syndrome%20(GBS),with%20a%20virus%20or%20bacteria.

Guillain-Barré Syndrome. (2023, March 8). National Institute of Neurological Disorders and Stroke.

Retrieved June 28, 2023, from https://www.ninds.nih.gov/health-information/disorders/ guillain-barre-syndrome

Mayo Clinic Staff. (2022, June 14). Guillain-Barre syndrome.
Mayo Clinic. Retrieved June 28, 2023,

from https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793

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