Guillain-Barré Syndrome: A Serious Autoimmune Disease

What is Guillain-Barré Syndrome (GBS)?

Guillain-Barré Syndrome (GBS) or acute inflammatory polyradiculoneuritis is a rare autoimmune disease of the peripheral nervous system. This disease affects the roots emerging from the spinal cord and peripheral nerves, without affecting the spinal cord and brain. It was named after the neurologists who first described it in the early 20th century.

In Guillain-Barré Syndrome, the immune system creates antibodies that target the myelin sheath of motor and sensory nerves, or axons. This attack causes inflammation of the nerves, dysfunction, and sensory and motor symptoms.

The cause of the syndrome is not always clear. Often, the production of autoantibodies is triggered by an infection . The syndrome can follow 2 to 3 weeks after the onset of symptoms of the infection. Potentially, all infections, viral and microbial, can trigger the syndrome. There is a greater association with gastrointestinal infections, such as those caused by Campylobacter jejuni, where the clinical picture is usually more severe. Other viral infections that have been implicated include influenza, Epstein–Barr, and cytomegalovirus. More rarely, the syndrome has been associated with vaccinations .

Clinical picture and symptoms

The syndrome usually begins with a symmetrical feeling of numbness or pain in the upper and lower extremities, starting peripherally and progressing upward.

Muscle weakness often coexists with the same ascending course, resulting in impaired or even inability to walk and use the upper limbs. Other symptoms may include facial nerve palsy, often bilateral, diplopia, and ataxia. In severe syndrome, the muscles of breathing and swallowing may also be affected. This can lead to difficulty swallowing, shortness of breath, and the need for mechanical ventilation, as well as transfer to an intensive care unit.

In addition, there are often autonomic nervous system disorders . These include blood pressure disorders, heart rhythm disorders, and bowel and bladder disorders. Depending on the type of syndrome, different symptoms may be prominent.

Diagnosis

GBS requires early diagnosis and treatment, as it can be potentially fatal if left untreated. After initial clinical suspicion, the diagnosis is confirmed by clinical examination . This reveals symmetrical muscle weakness and loss of tendon reflexes. Laboratory testing with electromyography and electroneurography follows. These tests show abnormal motor and sensory conduction velocities. Lumbar puncture may also show high leukocytosis without the presence of abnormal cells (albuminocytosis). Testing for specific antibodies is an additional tool for diagnosing and determining the type of GBS.

Treatment & Treatment

Treatment should begin immediately after diagnosis. The goal is to address the immune stimulation. Available treatments include intravenous immunoglobulin for 3 to 5 days, depending on the severity of the disease. Plasmapheresis also removes autoantibodies, reducing the severity and accelerating recovery from the syndrome. In addition to specific treatments, systematic physical therapy, supportive care of the patient, and management of complications are important. The main concern is respiratory support and management of autonomic disorders.

Forecast

The majority of patients recover completely or with minimal sequelae. The acute phase usually lasts 1–4 weeks, with stabilization and partial recovery following. Recovery is often complete in 3–6 months, although it may take up to 2 years, especially in severe cases. In these cases, residual neurological deficits may remain. A small proportion (<5%) may experience serious complications or death without early treatment.

Conclusion

GBS is a rare but serious autoimmune syndrome that is often triggered by infections. Early diagnosis and treatment are crucial to avoid serious complications, including death. Neurolife strives to provide the best care for patients with GBS, focusing on individual needs and a human approach.