See also . . .
Autoimmune
Diseases
What is Guillain-Barre syndrome?
Guillain-Barre
(ghee-yan bah-ray) syndrome is a disorder in which the body's
immune system attacks part of the nervous system. The first
symptoms of this disorder include varying degrees of weakness
or tingling sensations in the legs. In many instances the weakness
and abnormal sensations spread to the arms and upper body. These
symptoms can increase in intensity until the muscles cannot
be used at all, and the patient is almost totally paralyzed.
This may include a temporary distortion of facial appearance
as facial muscles become paralyzed. In these cases the disorder
is life threatening -- potentially interfering with blood pressure,
heart rate, and breathing -- and is considered a medical emergency.
The patient is often put on a respirator to assist with breathing
and is watched closely for problems such as an abnormal heartbeat,
infections, blood clots, and high or low blood pressure. Most
patients, however, recover from even the most severe cases of
Guillain-Barre syndrome, although some continue to have minor
problems.
Guillain-Barre
syndrome can affect anybody. It can strike at any age and both
sexes are equally prone to the disorder. The syndrome is rare,
however, afflicting only about one person in 100,000. Usually
Guillain-Barre occurs a few days or weeks after the patient
has had symptoms of a respiratory or gastrointestinal viral
infection. Occasionally pregnancy, surgery, or vaccinations
will trigger the syndrome. The disorder can develop over the
course of hours or days, or it may take up to 3 to 4 weeks.
Most people reach the stage of greatest weakness within the
first 2 weeks after symptoms appear.
What causes Guillain-Barre syndrome?
No
one yet knows why Guillain-Barre strikes some people and not
others. Nor does anyone know exactly what triggers the disease.
What scientists do know is that the body’s immune system
goes awry and instead of attacking only foreign material and
invading organisms, it begins to destroy the myelin sheath that
surrounds the axons of many peripheral nerves. The myelin sheath
speeds up the transmission of nerve signals. As this protective
sheath disappears, signals slow and senses (heat, pain) decrease.
How is it Diagnosed?
Guillain-Barre
is called a syndrome rather than a disease because it is not
clear that a specific disease-causing agent is involved. Reflexes
such as knee jerks are usually lost. Because the signals traveling
along the nerve are slower, a nerve conduction velocity (NCV)
test can give a doctor clues to aid the diagnosis. The cerebrospinal
fluid that bathes the spinal cord and brain contains more protein
than usual, so a physician may decide to perform a spinal tap.
Can it be Treated?
There
is no known cure for Guillain-Barre syndrome, but it will usually
go away with time. There are therapies that can lessen the severity
of the symptoms and accelerate the recovery in most patients.
There are also a number of ways to treat the complications of
the disease. Currently, plasmapheresis and high-dose immunoglobulin
therapy are used. Plasmapheresis is a procedure in which abnormal
antibodies are removed from the blood, which seems to reduce
the severity and duration of the Guillain-Barré episode.
Intravenous high-dose immunoglobulin therapy temporarily modifies
the immune system and provides the body with normal antibodies
from donated blood. The most critical part of treatment for
this syndrome consists of keeping the patient's body functioning
during recovery of the nervous system. This can sometimes require
placing the patient on a respirator, a heart monitor, or other
machines that assist body function.
What is
the long-term outlook for those with Guillain-Barre syndrome?
Guillain-Barre
syndrome can be a devastating disorder because of its sudden
and unexpected onset. In addition, recovery is not necessarily
quick. As noted above, patients usually reach the point of greatest
weakness or paralysis within the first two weeks. Symptoms then
stabilize at this level for a period of days, weeks, or, sometimes,
months. The recovery period may be as little as a few weeks
or as long as a few years. About 30% of those with Guillain-Barre
still have a residual weakness after 3 years. About 3% may suffer
a relapse of muscle weakness and tingling sensations many years
after the initial attack.
Guillain-Barre
syndrome patients face not only physical difficulties, but emotionally
difficult events as well. It is often extremely difficult for
patients to adjust to sudden paralysis and dependence on others
for help with routine daily activities. Patients sometimes need
psychological counseling to help them adapt.
For More Information . . .
You can find out more about Guillain-Barre Syndrome by contacting
the following organizations:
National Institute of Neurological Disorders and
Stroke, NIH, HHS
Phone: (301) 496-5751
Internet Address: http://www.ninds.nih.gov/
National Organization for Rare Disorders
Phone: (800) 999-6673
Internet Address: http://www.NORD-RDB.com/
Guillain-Barre Syndrome Foundation International
Phone: (610) 667-0131
Internet Address: http://www.guillain-barre.com/
This information was abstracted from fact sheets
developed by the Office on Women's Health in the Department
of Health and Human Services and the National Institute of Neurological
Disorders and Stroke.
All material contained in the FAQs is free of
copyright restrictions, and may be copied, reproduced, or duplicated
without permission of the Office on Women's Health in the Department
of Health and Human Services; citation of the source is appreciated.
