Guillain-Barré syndrome is an inflammatory disorder that damages the body’s immune system. The condition results in weakness and numbness in extremities and finally, paralysis.
Guillain-Barré syndrome is a health condition that is the result of an immune response to foreign antigens. The response to infectious agents damages the host nerve tissues in a sort of antigenic mimicry, and the targeted gangliosides are, in fact, complex glycosphingolipids. Trigger factors like Campylobacter jejuni are the primary antecedent infections that spark the onslaught of this syndrome. The result is a ruthless attack or inflammation of myelin, that brings on muscle paralysis. The condition is commonly accompanied by distinct autonomic disturbances.
Causes
Though the exact cause of this disease is highly debated, it could be brought on by something as common as a stomach flu. It is primarily the result of immunopathological reaction, and rarely, serum sickness. It has six subtypes:
- Acute inflammatory demyelinating polyneuropathy (AIDP)
- Miller-Fisher syndrome (MFS)
- Acute motor axonal neuropathy (AMAN)
- Acute motor sensory axonal neuropathy (AMSAN)
- Acute panautonomic neuropathy
- Bickerstaff’s brainstem encephalitis (BBE)
The primary causes include:
- Autoimmune response against Schwann cell membranes
- Attack on the motor nodes of Ranvier, the axoplasm of peripheral nerves
- Attack on sensory nerves, leading to severe axonal damage
- Accompanying cardiovascular involvement and dysrhythmias
- Irregular hyperintense lesions in the brainstem – pons, midbrain, and medulla
Effects
This condition is an autoimmune disorder that affects the peripheral nervous system. It is triggered by an infectious process, and is clinically included within peripheral neuropathies. It manifests in the form of ascending paralysis and a weakness in the legs. The pain and numbness spreads to the upper limbs, and reaches as far as the face. The total collapse of the deep tendon reflexes can only be addressed via prompt treatment. There have been instances of the condition culminating in death in the case of severe pulmonary complications, and/or the onset of dysautonomia.
Symptoms
The disorder is characterized by:
- Lower limb weakness
- Dysesthesias in the arms and facial muscles
- Bulbar weakness in the lower cranial nerves
- Oropharyngeal dysphagia
- Respiratory difficulties
- Sensory loss, loss of proprioception, and areflexia
- Loss of sensation, with regards to pain and temperature
- Bladder dysfunction
- Spinal cord disorder
- Fever and fluctuations in blood pressure
- Paralysis and central pontine demyelination
Treatment
- Myelin and axon loss are the typical features of this condition. It is addressed after a thorough clinical analysis with the help of plasmapheresis and/or intravenous immunoglobulins.
- Supportive care plays a key role in recovery, and in strengthening the patient’s resolve and immunity to regain previous functional capacity. This mainly demands monitoring of vital functions.
- The treatment options include high-dose, intravenous immunoglobulins, plasmapheresis, physical therapy directed towards the activities of daily life (ADL) independence, and glucocorticoids in some cases.
- The patients and doctors bank heavily on physiotherapy. The treatment plan, at all times, involves a detailed and dedicated, progressive, training program and guidance to improve functional movement.
- The role of the speech and language therapist is very important for the patient to regain communication ability after a tracheostomy.
Prognosis
Although, on record is the fact that with the help of timely action, recovery ideally begins from the 4th week onwards, the phase could very well stretch beyond a year. Also, it is possible only if remyelination occurs. However, on the contrary, axonal degeneration occurs, which is again a condition that can be corrected, only when an opposite ‘regeneration’ is triggered. Recovery is not only slow, but also only after a major residual damage.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.
