What is Guillain-Barre Syndrome?
by Beth G. Hodges, MD

Guillain-Barre is a syndrome of progressing muscle weakness, loss of reflexes, and numbness and/or tingling. It is very rare, but most affected individuals do recover.

Cause of Guillain Barre Syndrome

Guillain-Barre is thought to be auto-immune mediated, meaning that the immune system attacks a part of the body, in this case the myelin sheaths covering nerves. It is usually triggered by a virus or a bacterial infection, or in rare cases, the influenza vaccine. Some of the more common precursor infections are campylobacter food poisoning, mycoplasma pneumonia, cytomegalovirus infection (CMV), Epstein Barre Virus infection (mononucleosis), and varicella (chicken pox) infection.

Symptoms

Guillain-Barre syndrome usually starts with numbness and tingling of the distal extremities, accompanied by muscle weakness of those affected areas. It progresses proximally towards the center of the body. It can go on to include paralysis of the eye muscles and difficulty with speaking and swallowing. After about four weeks, the symptoms will gradually recede.

Guillain-Barre syndrome can be diagnosed by a careful history and physical exam by a physician and confirmation of the diagnosis is usually sought through consultation by a neurologist. The neurologist will usually perform nerve conduction testing and a lumber puncture, mostly to rule out competing diagnoses.

Treatment of Guillain Barre Syndrome

Once a diagnosis of Guillain-Barre syndrome is confirmed, treatment can be initiated one of two ways. Intravenous immunoglobulin (IVIG) can be administered or plasma exchange can be performed. IVIG gives the body the ammunition it needs to fight off the disorder and restore normalcy. Plasma exchange involves removing the blood from the body, taking out the harmful antibodies and then putting the blood back into the body. IVIG is obviously a less invasive procedure.

The other aspect of Guillain-Barre syndrome treatment is supportive care to make sure the affected person has no difficulty breathing or swallowing food safely. Once the symptoms start to recede, recovery can occur quickly or may take some time and physical therapy, depending on the severity of the symptoms.

Published - December, 2009