Guillain-Barre Syndrome: Causes, Symptoms, Diagnosis, Treatment, and Prevention
The Guillain-Barre syndrome affects the nerves outside of the brain and spinal cord and can cause muscle weakness, numbness, tingling, pain, and even paralysis. In adults, GBS is more common than in children, but it can affect anyone at any age. If GBS affects breathing muscles or the heart and blood pressure, it can be life-threatening, but most people recover from it with proper care.
What causes Guillain-Barre syndrome?
It is believed that GBS is caused by an autoimmune reaction. The immune system mistakenly attacks the nerves that control the muscles, which normally protects the body against infections and diseases. As a result, nerve signals are slowed or blocked because the protective covering of nerves called myelin is damaged.
The symptoms of GBS are usually triggered by an infection a few days or weeks before they appear. The infection may be bacterial, viral, or parasitic.
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Campylobacter jejuni, a bacteria that causes food poisoning
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Influenza virus, which causes the flu
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HIV, which causes AIDS
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Zika virus, which is spread by mosquitoes
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Cytomegalovirus (CMV), which causes fever and fatigue
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Epstein-Barr virus (EBV), which causes mononucleosis (mono)
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Mycoplasma pneumoniae, which causes respiratory infections
Other factors that may increase the risk of GBS are:
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Surgery
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Vaccination
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Hodgkin’s lymphoma, a type of cancer that affects the lymph nodes
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Pregnancy
What are the symptoms of Guillain-Barre syndrome?
Symptoms of GBS can vary from person to person and can change over time. A common symptom of GBS is muscle weakness that begins in the feet and legs and spreads to the upper body. People may experience mild or severe weakness on either side of the body. Some may also experience:
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A pins and needles sensation in the fingers, toes, ankles, or wrists
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Difficulty with facial movements, such as speaking, chewing, or swallowing
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Double vision or inability to move the eyes
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Severe pain that may feel achy, shooting, or cramp-like and may be worse at night
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Difficulty with bladder control or bowel function
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Rapid heart rate
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Low or high blood pressure
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Difficulty breathing
Some people may experience mild symptoms that improve quickly, while others may experience severe symptoms that last for months or years. Symptoms usually develop over hours to days and peak within two to four weeks. Some people may experience lasting effects such as numbness, fatigue, or weakness after experiencing GBS.
How is Guillain-Barre syndrome diagnosed?
GBS cannot be diagnosed with just one test. It is diagnosed based on signs and symptoms, medical history, physical examination, and some tests that can rule out other causes of muscle weakness. Some of the tests may include:
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Nerve conduction studies (NCS), which measure how fast the nerve signals travel along the nerves
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Electromyography (EMG), which records the electrical activity of the muscles
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Lumbar puncture (LP), also known as a spinal tap, which involves taking a sample of fluid from the lower back of the spine and checking it for signs of inflammation or infection
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Blood tests, which can check for antibodies or infections that may be associated with GBS
How is Guillain-Barre syndrome treated?
GBS cannot be cured, but there are treatments that can reduce the severity and duration of symptoms and prevent complications. The treatments are usually given in a hospital setting and may include:
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The use of intravenous immunoglobulin (IVIG) involves injecting antibodies from healthy donors into a vein in order to prevent harmful antibodies from attacking nerves.
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The process of plasmapheresis (PLEX), also known as plasma exchange, involves taking some blood from the body and separating it into plasma and blood cells. Using a plasma substitute or donated plasma, the harmful antibodies can be removed from the blood.
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Monitoring vital signs such as heart rate and blood pressure, providing oxygen therapy or mechanical ventilation if needed, managing pain with medications, preventing infections with antibiotics, preventing blood clots with anticoagulants, preventing bed sores with frequent position changes, providing nutrition through a feeding tube if necessary, and providing physical therapy for regained strength and mobility.
There are several factors that influence the choice of treatment, including the type and severity of GBS, the availability of resources, and the patient’s preferences. There are a number of advantages and disadvantages between IVIG and PLEX, but each is equally effective. IVIG is easy to administer and has fewer side effects, but it is more expensive and may not be available everywhere. PLEX is cheaper and more widely available, but it is more invasive and has more risks, such as bleeding, infection, and allergic reactions.
Based on the patient's response, the treatment typically lasts a few days to a week. Most people begin to recover after the treatment within a few weeks, but some may take longer. Depending on the extent of nerve damage and the presence of complications, recovery may be partial or complete.
How can Guillain-Barre syndrome be prevented?
There is no specific way to prevent GBS, but some general measures that can help reduce the risk of infections that may trigger GBS are:
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Practicing good hygiene, such as washing hands frequently, especially before eating or after using the bathroom
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Avoiding contact with people who are sick or have symptoms of infection
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Getting vaccinated against diseases that may cause GBS, such as influenza, hepatitis B, or tetanus
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Cooking food thoroughly and avoiding raw or undercooked meat, poultry, eggs, or seafood
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Drinking safe water and avoiding contaminated water sources
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Using insect repellents and wearing protective clothing to prevent mosquito bites
Getting any vaccination or surgery should be avoided if you have had GBS before. If you notice any signs or symptoms of GBS, such as muscle weakness, numbness, tingling, or pain, you should seek medical attention immediately. Early diagnosis and treatment can improve outcomes and prevent serious complications.
