A 65 year old man was relaxing in his chair reading the daily when he felt a tingling sensation in his legs. He stood up and walked for 15 minutes and thought it would go away but the sensation slowly spread to his arms. Gradually within few days, the symptoms started becoming severe, and within 2 weeks, his left side became paralyzed. He felt difficulty in breathing and was rushed to the emergency. The doctor diagnosed his condition to be Guillan- Barre syndrome. Fortunately, the patient recovered completely after treatment.
Understanding Guillan- Barre syndrome
Guillan- Barre syndrome is a rare disorder that affects the nerves present outside the spinal cord and brain. It is a rare form of medical condition where the affected person will have a type of paralysis. The person affected can return back to normal life after recovery. Out of 100,000 people only 1 or 2 are affected by the Guillan- Barre syndrome.
The peripheral nerves are nerves that are present outside the brain and spinal cord. They help in moving the muscles of the body by transmitting signals from the brain to the muscles. They also transmit sensory signals like sensation of pain, touch, temperature, and pressure from the body (sense organs) to the brain. The nerves may get temporarily damaged due to Guillan- Barre syndrome which causes disruption of signals causing tingling and numbness in the legs and arms. The person affected will have difficulty in moving, and may experience weakness. If the chest muscles are affected, then the person experiences difficulty in breathing. Fortunately, this paralysis like condition is only temporary.
Causes
The exact cause of Guillan- Barre syndrome is not known. It is reported that Guillan- Barre syndrome may occur after a bout of bacterial or viral infection like diarrhea or sore throat. This does not mean that all cases of diarrhea, common colds or sore throats lead to this syndrome. The Guillan- Barre syndrome happens rarely, and is believed to be an autoimmune disorder. The body’s immune system helps in fighting the invading bacteria but in an auto immune disorder the immune system affects body’s own cells mistaking them to be harmful foreign bodies. The Guillan- Barre syndrome affects people of the older age group more than the others.
Symptoms
The initial symptoms may appear as tingling sensation in the arms and legs. The person feels extremely weak. This tingling sensation spreads to the upper body and the person loses reflexes like the knee jerk reaction on testing by the doctor. Within 2 weeks, severe symptoms appear in which paralysis of certain muscles takes place. The person will not be able to swallow or breathe. Though the condition looks frightening, the patients do recover completely after treatment.
Diagnosis
A syndrome means a group of symptoms. Hence, the doctor first tries to take the complete medical history of the patient to understand all the symptoms. The doctor conducts a lumbar puncture in which a small amount of cerebrospinal fluid is taken from the spinal canal at the lower back and tested in the lab for Guillan- Barre syndrome. The doctor also conducts nerve conduction studies in which electric current is sent to stimulate the muscles and nerves. The response is then studied by the doctor. An electromyography is conducted in which the electrical activity of the muscles is studied by which the doctor will determine whether the weakness is being caused by damage to the nerves or muscles.
Treatment
Guillan- Barre syndrome has no cure; usually the symptoms worsen, then reach a plateau where the symptoms do not aggravate, thereafter, the recovery process starts. To reduce the severity of the symptoms and speed up recovery, treatments like plasmapheresis and intravenous immunoglobulin therapy are given. In the procedure called as plasmapheresis, plasma exchange treatment is done in which the antibodies that are damaging are removed from the blood. This is a type of ‘blood cleansing’ procedure. The liquid portion of blood which is called as plasma is separated from the blood cells and then transferred back into the body. These blood cells now start forming new plasma as a means to compensate for the lost plasma. This procedure of plasmapheresis gets rid of antibodies that trigger immune system attack on peripheral nerves. Intravenously (through vein) immunoglobulins are taken from blood donors that contain healthy antibodies and are transferred into the patient. These immunoglobulins help in blocking the damaged antibodies that give rise to Guillan- Barre syndrome.
Additional assistance
After treatment at the hospital, physical therapy is given to strengthen the muscles. The caregivers may manually move the patient’s hands and legs to keep the muscles strong and flexible. Self care skills are taught and training is given with the help of adaptive devices like braces and wheel chair which will help the patient in mobility.
Discoverers of Guillain-Barré Syndrome
The Guillain-Barré was discovered by the French Physicians Jean Alexander Barre and Georges Guillain, and Andre Strohl who described it in the year 1916 AD after they conducted tests on soldiers who returned from World War 1.
