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Guillain Barre Syndrome (also known as acute ascending polyneuritis) is a type of acute polyneuropathy that produces rapidly worsening weakness of muscles, in some cases causing paralysis. The main cause of Guillain Barre Syndrome is an auto-immune reaction – the immune system of the body attacks the myelin sheath. In approx. 80% of individuals, symptoms start about five days to three weeks after a surgery, immunization or mild infections. Guillain Barre Syndrome generally starts with tingling, loss of sensation, and weakness in both legs, then develops upward to the arm. Weakness is the most common symptom of this disorder. In 90% of individuals with Guillain Barre Syndrome, weakness is more severe within two to three weeks. In 5 to 10%, the muscle that supports breathing, becomes so weak that a respirator is required. Approx. 10% is required to be fed through a gastrostomy tube or intravenously because the swallowing and facial muscles become weak. In severe cases of Guillain Barre Syndrome, the blood pressure can flunctuate, or the individual can have an abnormal heart beat or other autonomic nervous system dysfunctions. One type of this disorder produces unusual symptoms group, where eye movements become paralyzed, normal reflex disappears, and walking is difficult. About 5% of patients with this disease die. Since laboratory tests may not specifically diagnose this disorder, a physician should recognize the Guillain Barre Syndrome from symptoms pattern. Testing of cerebrospinal fluids from the column of spine, nerve conduction study, blood tests, and electromyography are done usually to eliminate other possible profound weakness causes. The disease is very serious and needs prompt hospitalization because it may worsen fast. The sooner diagnosis is confirmed, the sooner proper treatment can begin, the better the prognosis of recovery. Individuals with Guillain Barre Syndrome are carefully monitored so that breathing may be assisted with respirators, if needed. A nurse takes precaution to prevent injuries and bed sores by providing soft mattress and turning the patient every two hours. Physical therapies are essential to prevent muscle tightening and to preserve muscle and joint function. The treatment of Guillain Barre Syndrome consists of infusions of autoimmune globulin and plasmapheresis. Patients with this disorder may get better on their own, but recovery process will be much longer without treatment. In earlier stages of treatment, patients may improve very fast, within days or weeks. Otherwise, recovery takes a few months, but most individuals recover almost completely. About 30% of patients experience residual weakness after three years. After initial improvement, approx. 10% of the patients relapse and progress chronic relapsing polyneuropathy. Corticosteroids and Immunoglobulin can be helpful for this persistant type of Guillain Barre Syndrome. Medications and plasmapheris that suppress the immune system may also be helpful.
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