Guillain-Barré syndrome (GBS) is a problem with the nervous system. It causes loss of reflexes, muscle weakness, and numbness or tingling in arms, legs, face, and other parts of the body. This condition can cause paralysis and even death. However, most people recover and have few lasting problems. It is important for patients and doctors to see through the duration of Guillain Bureau syndrome to the likelihood of eventual recovery.
Causes of GBS are still unknown. Many experts believe that the nerves are attacked by the body’s own defense system, which is called an autoimmune disease. In GBS, the immune system attacks the covering of certain nerves, leading to nerve damage. Infections may also trigger GBS, including:
- Campylobacter jejuni, leading to a type of food poisoning
- Cytomegalovirus (CMV), causing fever, chills, body aches, sore throat, swollen glands, and fatigue
- Epstein-Barr virus (EBV), triggering mononucleosis (mono)
- Mycoplasma, causing pneumonia
- Varicella-zoster virus, the main cause of chickenpox and shingles
2. Signs and Symptoms
Symptoms of GBS include:
- Back pain
- Not being able to move your eyes
- Trouble speaking, chewing and swallowing
- Muscle weakness in your legs, arms, and both sides of your face
- Numbness or tingling in your feet, hands, and sometimes around the mouth and lips
The first symptom is numbness or tingling in toes and fingers. Over several days, muscle weakness develops in the legs and arms. After four weeks, most people begin to feel better. Treatment in the hospital is required for the first few weeks since the condition can be fatal if weakness spreads to muscles that control breathing, heart rate, and blood pressure. Go to the hospital right away if you think you might have GBS.
GBS can be difficult to diagnose since the symptoms may be vague and unrelated. Diagnosis requires a few tests including a lumbar puncture, muscle activity tests, muscle strength tests, physical examination, nerve conduction velocity tests, reflex tests (e.g., the knee-jerk reaction) and spinal tap (check for higher than normal levels of protein in the cerebrospinal fluid). If the diagnosis is not clear yet, you may be referred to a doctor who majors in the nervous system (neurologist).
Tell the doctor when your symptoms began and how they have changed. If you have had any recent infections, do not forget to tell him or her. Two signs are crucial in helping your doctor to decide if you have GBS:
- Your arms and legs are becoming weaker.
- You are losing your reflexes – automatic body movements that you cannot control.
GBS is usually treated in the hospital. The healthcare staff will watch you carefully to make sure you do not become worse or contract an infection. Your breathing, heart rate, and blood pressure will also be tracked. Some patients may need a ventilator to breathe. In a plasma exchange, blood is removed out of your body. The harmful antibodies are ruled out of the blood, and then the blood is returned to the body. In intravenous immunoglobulin (IVIG), helpful antibodies are added to the blood.
These treatments may help the body fight off the disease and speed the recovery if you use them when you first get sick. You may have to stay in the hospital for weeks until your symptoms have relieved. Sometimes this condition can reoccur. Both plasma exchange and IVIG therapy are needed to reduce the severity of a relapse.
5. ICU Treatment
- Respiratory Therapy
Approximately one-third of GBS patients requires ventilatory support. If doctors want to anticipate complications, they have to monitor for respiratory failure, bulbar weakness, and troubles with swallowing. Assessment of ventilatory status is necessary, including pulse oximetric monitoring and measurements of vital capacity. Respiratory assistance should be contemplated when the expiratory vital capacity falls to less than 18 mL/kg or when a decline in oxygen saturation is remarkable (arterial PO2 < 70 mm Hg).
- Cardiac Monitoring
Close monitoring of cardiac arrhythmias, heart rate, and blood pressure allows early diagnosis of fatal situations. Patients require telemetry and medical supervision in an ICU setting. Patients with autonomic instability can take antihypertensives and vasoactive drugs with caution. They rarely require long-term medications to heal blood pressure or cardiac problems.
Enteral or parenteral feedings are necessary for patients on mechanical ventilation to make sure that adequate caloric needs are satisfied when the metabolic demand is high. Even those who are off the ventilator may demand nutritional support if dysphagia is serious. Precautions against dietary manipulations should be conducted to prevent aspiration and pneumonia in patients at risk.
Recovery may need three to six months or longer. You may have to wait a few months before you can return to your routine activities. Many people suffer long-term effects, such as numbness in toes and fingers. In more severe cases, patients may suffer long-term weakness, balance problems, or even paralysis. Support at home is critical during this time. You will need some help with your everyday chores and activities until you are better. Regular exercise can assist in strengthening your weakened muscles. Consult with your doctor about exercising during your recovery. Physical or occupational therapy is useful if you have severe muscle weakness.
7. Long-term Outlook
Around nine out of ten people with GBS survive; 75 to 90 percent recover fully. Around 10 to 15 percent will be troubled by some permanent disabilities. In general, the earlier the symptoms begin to ease, the better the prognosis. Even so, it may take from six months to two years or more to recover completely. Physical therapy is essential since it prevents muscle contractures and accompanied deformities. Healthcare providers involved in the patient’s rehabilitation may include social workers, neurologists, physiotherapists, psychologists, and occupational therapists.
GBS is an autoimmune condition wherein the patient’s nerves are attacked by the body’s immune defense system. Consequently, the nerve insulation and even the inner covered part of the nerve are damaged, and signals are delayed or changed. Other names for Guillain-Barrè syndrome include Guillain Bureau syndrome, Landry’s ascending paralysis, acute idiopathic polyneuritis, and acute idiopathic polyradical neuritis.
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