Guillain–Barré

Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. The initial symptoms are typically changes in sensation or pain along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body, with both sides being involved. The symptoms develop over hours to a few weeks. During the acute phase, the disorder can be life-threatening, with about 15% developing weakness of the breathing muscles and therefore requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.

Causes

It is believed that GBS is caused by an infection that triggers the immune system to attack the peripheral nerves. The exact cause is unknown, but it is often preceded by an infection, such as a respiratory tract infection or the stomach flu. The mechanism involves an autoimmune attack on the peripheral nerves, damaging their myelin insulation and impairing signal conduction. This results in the characteristic symptoms of GBS.

Diagnosis

Diagnosis is usually based on the signs and symptoms, through the exclusion of alternative causes, and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid. In the cerebrospinal fluid, protein levels are often increased, while the cell count is normal, a phenomenon known as albuminocytological dissociation.

Treatment

There is no known cure for GBS, but treatments can help speed recovery and manage symptoms. These treatments include plasma exchange (plasmapheresis) and high-dose immunoglobulin therapy. Physical therapy can also help to improve muscle strength and function.

Prognosis

The long-term outlook for people with GBS varies. Most people recover fully, but some have permanent nerve damage. In rare cases, people have died of complications, especially if the syndrome is not diagnosed and treated promptly.

See also

• Peripheral neuropathy
• Autoimmune disease
• Plasmapheresis
• Immunoglobulin therapy

References

Guillain–Barré Resources
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