GUILLAIN-BARRE SYNDROME

Guillain-Barré (ghee-yan bah-ray) syndrome is a disorder in which the body's immune system attacks our own peripheral nervous system, usually triggered by an acute infectious process. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks. The symptoms start in the legs which get weak and tingly. The paralysis spreads to the upper limbs and the face along with complete loss of deep tendon reflexes (knee jerks). All forms of Guillain-Barre syndrome are due to an immune response to foreign antigens (such as infectious agents or vaccines) but mistargeted to host nerve tissues instead. The end result of such autoimmune attack on the peripheral nerves is inflammation of myelin and subsequent conduction block, leading to a rapidly evolving flaccid paralysis. Frequently, the lower cranial nerves may be affected, leading to bulbar weakness (causing difficulty with eye movements, double vision), oropharyngeal dysphagia (difficulty with swallowing, drooling, and/or maintaining an open airway). In severe cases of GBS, loss of autonomic function is common, manifesting as wide fluctuations in blood pressure, orthostatic hypotension, and cardiac arrhythmias.

Prompt treatment with plasmapheresis followed by immunoglobulins and supportive care, the majority of patients will regain full functional capacity. The most critical part of the treatment for this syndrome consists of keeping the patient's body functioning during recovery of the nervous system. This can sometimes require placing the patient on a respirator, a heart monitor, or other machines that assist body function.