Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is a rare condition that occurs when the body’s immune system attacks and damages the peripheral nerves, which extend out from the brain and spinal cord. The condition can range from mild to severe and can require emergency medical treatment and hospitalization if it affects breathing or the patient’s heart rate. Cases of GBS are typically temporary and patients usually recover even from severe cases.

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Symptoms

The most common early symptom of GBS is weakness and tingling in the legs and feet that can spread to the upper body. This often develops into more serious symptoms including:

  • Difficulty walking
  • Difficulty with eye movement
  • Difficulty with facial movement
  • Difficulty speaking
  • Difficulty chewing
  • Difficulty swallowing
  • Changes in blood pressure
  • Difficulty breathing
  • Difficulty controlling bladder
  • Rapid heart rate

These symptoms can progress over several hours or even weeks. Most patients experience a peak in their symptoms between two and four weeks after they first notice them. It is important to seek immediate medical attention as these symptoms can become life threatening if they inhibit automatic bodily functions such as breathing or heart rate.

 

Causes and Risk Factors

The cause of GBS is unknown, although more than half of all cases are preceded by an infection affecting the lungs or digestive tract. In rare cases surgery, pregnancy or vaccinations may increase the risk of developing the condition. GBS can affect men and women equally and can occur at any age.

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Diagnosis

Diagnosis of GBS generally begins with a physical exam and review of the patient’s medical history. The symptoms of GBS can closely resemble other conditions and the physician will look for symptom patterns that will differentiate it from similar conditions.

Nerve conduction studies in conjunction with electromyography imaging (EMG) may be used to help with diagnosis based on fact that nerve signals travel slower in patients with GBS. A spinal tap (lumbar puncture) also may be performed to take a sample of the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. Patients with GBS often have more protein in their CSF and a lumbar puncture allows the physician to analyze this.

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Treatments

There is no cure for GBS, however, treatment can help manage the symptoms and promote recovery. Plasmapheresis, also known as plasma exchange, and intravenous immunoglobulin therapy are the main treatments for GBS.

Plasmapheresis involves removing blood from the patient’s body and running it through a process that separates the red and white blood cells from the liquid (plasma) they are carried in. The red and white blood cells are then replaced back into the body without the plasma and the body regenerates new plasma in response. How this process helps reduce symptoms in patients with GBS is not fully understood; however, it is believed this procedure may relieve the symptoms of GBS because it removes immune cells from the blood that may be causing nerve damage.

Intravenous immunoglobulin therapy involves the patient with GBS receiving high doses of good antibodies from blood donated by healthy individuals. The healthy antibodies can help block the antibodies that may be contributing to the GBS symptoms and attacking nerves inside the body.

The knowledgeable staff at the Cedars-Sinai Department of Neurology and will work with each patient and their family to determine the best treatment option.

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