Etiology, Treatment – Guillain-Barré Syndrome

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Table of Contents

Etiology
Pathophysiology
Signs & Symptoms
Diagnosis
Available treatment options
Case Management
Prognosis
Conclusion and comments
References

The Guillain-Barré Syndrome, also known as the Landry’s paralysis, is a rare acute autoimmune disorder that attacks the peripheral nervous system. This is the part of the nervous system that links the brain to the spinal cord. The complications brought about by this condition can be life threatening. They affect blood pressure and heart rate. The syndrome makes feet and hands weak, and spreads towards the trunk. That is the main symptom, although sub-types of the syndrome may render the automatic nervous system dysfunctional (Sivadon 48-56). In extreme cases, it affects the respiratory muscles as well. It is experienced by both sexes at any age. However, it is most common at the age from thirty to fifty years. Just like many other life-threatening conditions, the disease comes as a result of an infection.

Etiology

The causality of the Guillain-Barré Syndrome has not yet been established. It is not even known why the disease strikes specific people only. It is, however, known that the disease is not contagious. The syndrome comes about when the immune system responds to antigens that are foreign (Haber 2478-2481). The foreign antigens target the nerve tissues in a process known as the molecular mimicry. The attacks affect the gangliosides, which in turn affect the peripheral nerves because the gangliosidesare found in the peripheral nerve tissues. Other cases of the disease may be caused by the influenza virus. When there was a swine flu pandemic between 1976-1977, cases of the syndrome were reported to have increased.

Pathophysiology

The disease is autoimmune in nature and comes about when the immune system fights the body. In a normal situation, the immune system only attacks material that is foreign. However, in Guillain-Barré Syndrome, the system attacks the myelin sheath surrounding the peripheral nerve axons. In this regard, arms and legs are the most affected because the transmission of signals to them takes a long period of time compared to other body parts. Before spreading to other parts of the body, the disease causes weakness in hands and lowerlimb muscles.

Signs & Symptoms

The symptoms of the Guillain-Barré Syndrome may take only a few hours to turn from mild to severe. Patients usually develop a symmetrical weakness in their feet, before rapidly progressing to the arms and other parts. The lower limbs become numb, while the legs buckle and become tingly. After a few hours or in some cases days, the effect is felt on the hands and facial muscles. In most cases, the effect also extends to the cranial nerves. This leads to drooling and difficulties in swallowing.Guillain-Barré Syndrome leads to fluctuations in the blood pressure and thiscan easily cause death.

Diagnosis

While diagnosing the Guillain-Barré Syndrome, a doctor tries to find out about the developments in the symptoms. He has to gather information about how they started, when, and how they have changed. A historical examination of the patient to find out if they have had any infections in the past is also done. The major signs that a doctor may use to diagnose you with Guillain-Barré Syndrome are weaknessesin the legs and arms, and reflex loss. Reflexes are the movements and reactions that the body makes which cannot be controlled by an individual (Kuwabara 529-533). To confirm the disease, varioustests are carried out. They include the study of the nerve conductions, as well as the lumbar puncture test. For a clear diagnosis, it is wise to visit a neurologist.

Available treatment options

Treatment of the Guillain-Barré Syndrome usually takes place in a hospital. It involves watching over a patient very carefully to ensure that they stay away from infections and that their condition does not worsen. The hospital staff must track the patient to ensure a manageableheart and breathing rate. When the respiratory system is badly affected, a breathing ventilator is provided. Blood is removed from the body and cleaned such that the harmful antibodies are removed. It is then returned to the body. This process is called the plasma exchange. In special conditions, antibodies that are vital are pumped into the blood through the IVIG therapy.

Case Management

During the initial weeks of the syndrome, plasma exchange and the IVIG are the most effective immune therapies for the pediatric patients. Plasma exchange is administered as a singledose in five occasions within the first and second weeks. There is no compelling evidence that links either of the therapies as being superior to the other. The patient should remain in hospital under close monitoring. Infections should be avoided by all costs.

Prognosis

Cure for Guillain-Barré Syndrome has not yet been established. With the proper administration of the therapy treatment, recovery should start after the fourth week. Within a few months, it is possible to recover fully. A few patients get disabled or develop other lingering effects (Wallace 157-163). Even with the best medical care, some patients succumb to the illness.

Conclusion and comments

Research has shown that men have a higher incidence of contracting the condition than women. The probability of contracting it also increases with age and pregnancy (Yuki 1205-1210). Studies have provided evidence that physiotherapyis good to the patients because it helps them regain muscular strength and endurance.

References

Haber, Peter. “Guillain-Barré syndrome following influenza vaccination.”JAMA. 292.20 (2004): 2478-2481. Print.

Kuwabara, Steven. “Does Campylobacter jejuni infection elicit “demyelinating” Guillain-Barré syndrome?.” Neurology. 63.3 (2010): 529-533. Print.

Sivadon, Tardy. “Guillain-Barré syndrome and influenza virus infection.”Clinical Infectious Diseases. 48.1 (2009): 48-56. Print.

Wallace, Sam. “Physiotherapy and Guillain–Barré syndrome: Results of a national survey.” Physiotherapy.95.3 (2009): 157-163. Print.

Yuki, Neo. “Campylobacter genes responsible for the development and determinant of clinical features of Guillain-Barré syndrome.”Japanese Journal of Clinical Medicine. 66.6 (2008): 1205-1210. Print.

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