When your Immune System attacks your nerves – Guillain-Barre Syndrome
Table of Content
Summary
Guillain-Barre syndrome is an auto-immune condition, in which the body’s immune system attacks its own nerves. The condition usually begins as slight muscle weakness or tingling sensations in the extremities, but escalates into major muscle weakness and paralysis very quickly. The condition is uncommon but still affects about 2 in 100,000 people. The exact cause of Guillain-Barre syndrome is uncertain, but having a prior bacterial or viral infection appears to trigger the condition. The condition requires immediate hospitalization and treatment to help prevent complications that could be fatal, including difficulty breathing and the inability to swallow. Guillain-Barre syndrome is treated with intravenous immunoglobulin therapy or plasma exchange therapy. The symptoms usually peak around 2 to 4 weeks after the onset of the condition, after which they begin to decline in intensity. Recovery can take anywhere from 6 months to 3 years. The recovery is sometime hard and painful, and involves extensive rehabilitation. However, most patients make an almost full recovery and go on to live relatively normal lives.
What is Guillain-Barre Syndrome?
Guillain-Barre Syndrome is a neurological auto-immune disorder that affects the peripheral nervous system, the part of the nervous system outside of the brain and spine. That means the body’s immune system attacks its own nerves, perceiving them as a threat. Guillain-Barre syndrome can develop quite suddenly and requires immediate hospitalization. According to neurologists, the symptoms of Guillain-Barre syndrome can begin quite subtly, with weakness and tingling sensations in the extremities, usually fingers and toes. However, the condition can escalate and become life-threatening very quickly. Thankfully, the condition is uncommon, but still affects 1 to 2 in 100,000 people.
Symptoms of Guillain-Barre Syndrome
Guillain-Barre syndrome begins with slight symptoms such as tingling sensations in the extremities, usually the fingers, toes and sometimes the face. The condition progresses quickly, and patients begin to exhibit other symptoms such as:
- Muscle weakness in the arms and legs
- Unsteady walking and an inability to balance
- Trouble with facial movements, including talking and eating
- Severe overall body pain
- Trouble with bladder and bowel control
- Difficulty breathing
- Rapid heart rate
- Difficulty moving your eyes
- Problems with vision
These symptoms tend to progress very quickly, often becoming debilitating within a few days. If this happens, you must treat it as an emergency and seek medical attention immediately. The earlier the patient can be treated, the better their chances of recovery.
What causes Guillain-Barre Syndrome?
When a patient is affected by Guillain-Barre syndrome, the immune system appears to become confused, and starts attacking the body’s own nerve cells. This self-inflicted damage affects the nerves’ ability to transmit signals to the brain. The exact cause of Guillain-Barre syndrome is unknown, but it is usually triggered by an infection. Many patients have developed the condition after suffering from a bout of diarrhoea or a respiratory infection. The bacteria campylobacter jejuni, Zika virus and Epstein-Barr virus appear to trigger Guillain-Barre syndrome in some patients. In rare cases, a recent surgery or vaccination can also trigger the condition.
Guillain-Barre Syndrome may be triggered by:
- A campylobacter infection – a type of bacteria often found in uncooked poultry
- Influenza virus
- Cytomegalovirus
- Epstein-Barr virus
- Hepatitis A,B,C or E
- HIV virus
- Hodgkin lymphoma
- Covid-19 virus
- Mycoplasma pneumonia
- Invasive surgery
- Trauma
- Vaccinations
It is noteworthy that the above mentioned triggers only affect a very small percentage of patients, and most patients who are affected by these bacteria or viruses do not develop Guillain-Barre syndrome.
Guillain-Barre syndrome can affect all ages, but the risk increases with age. It also appears to be slightly more common in men than women.
Types of Guillain-Barre Syndrome
Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) – This variant of Guillain-Barre syndrome occurs when the immune system attacks the myelin sheath (the layer of insulation) around nerve cells. Symptoms typically start with weakness and tingling in the legs and progress to paralysis and loss of reflexes.
Acute Motor Axonal Neuropathy (AMAN) – This type of Guillain-Barre syndrome affects the axons of motor nerves. The axons are the parts of the nerve cell that branch out and connect it to other nerve cells, muscles and other cells in the body. AMAN affects motor nerves in particular so patients affected experience acute paralysis and a loss of reflexes without losing their senses.
Acute Motor-Sensory Axonal Neuropathy (AMSAN) – AMSAN is similar to AMAN, however, both motor nerves and sensory nerves are affected. Patients with this variant tend to have a longer, more difficult recovery.
Miller Fisher Syndrome (MFS) – This is a rare type of Guillain-Barre Syndrome. Only about 5% of all Guillain-Barre syndrome cases are of this type. This variant causes paralysis of the eye muscles, absence of reflexes and lack of muscle coordination.
Diagnosis of Guillain-Barre Syndrome
Your neurologist will diagnose Guillain-Barre syndrome on the basis of a detailed medical history and an analysis of your symptoms. Guillain-Barre syndrome can resemble other neurological diseases so your doctor will likely go through a careful process of elimination to rule out other causes. They will also perform a neurological exam to test your speech, muscle strength, reflexes, co-ordination, balance and sensory perception.
They are also likely to recommend brain and spinal imaging tests such as an MRI. A spinal tap procedure known as a lumbar puncture may also be performed. This will test the cerebrospinal fluid around the spinal cord for abnormalities, such as elevated CSF protein levels, that could indicate Guillain-Barre syndrome. An electromyography and nerve conduction study may also be performed. These tests will check how well the nerves are able to conduct electrical impulses.
Treatment of Guillain-Barre Syndrome
Once a patient is diagnosed with Guillain-Barre syndrome, treatment must begin right away. The patient will likely be admitted to the hospital’s intensive care unit (ICU). This is so their breathing and blood pressure can be monitored constantly, both of which are complications of Guillain-Barre syndrome. There is no known cure for the condition, but the following treatments can reduce symptoms and help speed up recovery:
Plasma exchange (plasmapheresis) – Plasma is a component of blood, which forms the liquid medium. During plasma exchange, the patient’s blood is drawn and passed through a machine called a centrifuge. The centrifuge separates the blood cells from the plasma. The separated blood cells are returned to the patient’s bloodstream, along with other fluids. The separated plasma usually contains certain antibodies which are triggering the immune system’s attack on its own nerves, and hence is not pumped back into the body. The body makes new plasma to replace what was removed.
Intravenous Immunoglobulin therapy – Immunoglobulin is a part of the blood’s plasma containing antibodies. In this treatment, the patient is injected with immunoglobulin from healthy donors. The transfusion of healthy immunoglobulin helps stimulate the body to stop attacking its own cells.
In addition to these treatments, the patient may also be prescribed:
- Pain medication
- Medication to prevent blood clots
- IV fluids to prevent dehydration, especially if the patient cannot swallow
- Tube feeding, if the patient cannot swallow
- A breathing tube, if the patient cannot breathe
The distressing symptoms usually last 2 to 4 weeks, after which the patient will begin to slowly recover. Recovery can be a long process, and usually takes 6 to 12 months on average. For some patients, it can take as long as 3 years.
The rehabilitation program, once the patient has begun to recover, is crucial. The patient will work with a range of therapists to regain lost function:
- Physical therapy – This helps the patient regain lost muscle strength and tone. The patient will learn how to manage their pain, stiffness and physical discomfort. The patient will also be taught how to use their mobility aids, like walkers or wheelchairs, if needed.
- Occupational therapy – This assists the patient in developing the co-ordination they need to do daily tasks like sitting, standing up, eating and moving around safely.
- Speech therapy – If the patient’s speech was affected, they may need to re-learn how to use the muscles in their mouth and throat. This can help them learn to eat and speak normally again.
Long-term outlook for Guillain-Barre Symptom Patients
The long-term prognosis for Guillain-Barre syndrome varies. Most patients improve considerably over a period of time, with consistent treatment. The length of the recovery time varies and can take up to 3 years. Some patients never recover fully, and live with remaining muscle weakness.
Being diagnosed with Guillain-Barre syndrome can be emotionally taxing. Even for patients who recover fully, the treatment and rehabilitation process is painful. Many patients end up with limited mobility and chronic fatigue. To manage the stress of recovery and long-term deficits, it helps if the patient has a strong support system of family, friends and loved ones. We also recommend being part of a Guillain-Barre syndrome support group to connect with other recovering patients. Seeing a counsellor can also help navigate the emotional trauma of having suffered from this condition.
At the end of your journey towards understanding and recovery, Kauvery Hospital is here to support you. With branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, our expert team is dedicated to providing comprehensive care and advanced treatment options for Guillain-Barre Syndrome. Your health and well-being are our top priorities.
Frequently Asked Questions
What is Guillain-Barre Syndrome?
A rare autoimmune disorder where the immune system attacks the body’s nerves, causing weakness and sometimes paralysis.
What are the early symptoms of Guillain-Barre Syndrome?
Early symptoms of Guillain-Barre Syndrome include:
- Tingling sensations in the hands and feet
- Muscle weakness, especially in the legs
- Difficulty with balance and coordination
- Numbness in the limbs
- Severe pain, particularly at night
- Difficulty walking or climbing stairs
What causes Guillain-Barre Syndrome?
It often follows infections like flu, respiratory illness, or stomach infections. The exact cause is still unknown.
How is Guillain-Barre Syndrome diagnosed?
Diagnosis is based on symptoms, nerve tests, spinal fluid analysis, and MRI scans.
Can Guillain-Barre Syndrome be cured?
There’s no cure, but treatments like plasma exchange and immunoglobulin therapy can help speed recovery.
How long does recovery from Guillain-Barre Syndrome take?
Recovery time varies but typically takes 6 months to 3 years, depending on the severity.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai Alwarpet – 044 4000 6000 • Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
