Guillain-Barre Syndrome (GBS) is a rare disorder that affects the peripheral nervous system. It develops, usually over a period of weeks, in response to an infection or is an autoimmune disorder. The syndrome causes muscle weakness and sometimes paralysis. It is most often triggered by an infection with the Zika virus or immunization against tetanus.
Around 6,000 people in the US suffer from Guillain – Barre Syndrome each year. Guillain – Barre Syndrome occurs in 1 out of every 100,000 people. It is most common in young adults between the ages of 15 and 35 and middle-aged and elderly between ages 50 to 75; however, it can occur at any age. Current research shows that about 40% of these patients were infected with Campylobacter bacteria before developing the syndrome. Campylobacter is sometimes found in unpasteurized food and streams contaminated by sewage.
In Guillain – Barre syndrome, the immune system attacks healthy body tissue, causing immune cells to join with nervous system cells called neurons. When this occurs in the brain or spinal cord, it can cause paralysis and muscle weakness.
People with Guillain – Barre Syndrome usually experience their first symptoms while they are in an intensive care unit or emergency department for another condition. The person may experience difficulty swallowing or may notice that he is struggling to breathe.
Signs and Symptoms
Patients with GBS have numbness and tingling (paresthesias) that start in the feet and hands. As the disorder progresses, there is weakness, abnormal sensation, difficulty moving, and difficulty controlling bowel and bladder function.
Difficulty speaking and swallowing, paralysis of the facial muscles, loss of taste and smell, temporary blindness, and stroke-like symptoms.
Causes
GBS is usually caused by an autoimmune reaction to a viral or bacterial infection (immunization), injury (trauma), recent surgery, or treatment with certain drugs. In rare cases, it may be genetic.
Guillain-Barre syndrome is thought to be triggered when the body’s immune system attacks some part of the peripheral nervous system — nerves that connect the spinal cord in the brain to muscles and other organs. It is not clear why the immune system attacks the peripheral nervous system in Guillain-Barre syndrome.
The first symptoms of Guillain-Barre syndrome often follow a viral or bacterial infection. Most people who develop this syndrome have no family history of the condition, and it isn’t clear whether or not some people are genetically more susceptible to this disorder. Some research suggests that having had a recent viral or bacterial infection makes someone more likely to develop Guillain-Barre syndrome.
It is also possible that certain factors, such as bacterial infections, may trigger the syndrome in some people. Most cases occur within four weeks of infection.
The Zika virus is one cause of Guillain-Barre syndrome. Other viruses that can trigger the syndrome include dengue fever, cytomegalovirus, Epstein-Barr virus, and coxsackie viruses.
Immunization against tetanus can also trigger Guillain-Barre syndrome. The vaccine contains a type of protein from the bacteria that causes tetanus and is given to babies as part of routine immunizations.
It is not known how many people who have been diagnosed with Guillain-Barre syndrome will go on to develop other conditions, such as severe paralysis (paraplegia) or die. A small number of people with Guillain-Barre syndrome will have a lingering effect on the nervous system and may develop long-term problems with muscle weakness.
Treatment
The best treatment for Guillain – Barre syndrome is to gradually reduce your activity intensity and return as soon as possible to a normal level of activity.
The current treatment for Guillain – Barre syndrome is the drug plasma exchange. This involves filtering the patient’s blood and removing antibodies that attack healthy cells. The blood is then put back into the patient after it has been filtered.
Treatment of Guillain-Barre syndrome aims to reduce the risk that your immune system will attack your nerves. For this reason, doctors will often recommend treatment with intravenous immunoglobulin (IVIg) — a solution made from donated blood plasma. Early treatment with intravenous (IV) immunoglobulin (IVIG) often helps. This solution contains high levels of antibodies, which can help stop the immune system from attacking healthy nerves. The dosage and length of time people receive IVIg varies, but many people need to be hospitalized and given several treatments for around two weeks. It may take several weeks to start feeling better after starting treatment.
Many people with Guillain-Barre syndrome need to take drugs to protect their nerves from further injuries, such as antibodies called acetylcholinesterase inhibitors. These medications are usually taken for several months.
There is no known cure for Guillain – Barre syndrome. Intensive care and drug therapy are the only treatments that have proven to be beneficial.
Prevention
The best way to prevent this syndrome is to avoid being exposed to infections. This includes avoiding consuming food and water that have not been properly sanitized. You should also avoid crowds, especially if you feel unwell or suffer from a weakened immune system.
Other preventive measures include:
Avoiding the use of contaminated needles for injections or blood transfusions.
Notifying your doctor about any current infections or if you have experienced any previous infections. It will help prevent complications. If you have an infection, your doctor will treat it early and prescribe certain medicines to reduce the risk of complications.
Living a healthy lifestyle by not smoking, not abusing alcohol, and eating a well-balanced diet that contains essential nutrients such as zinc, iron, and vitamin B12.
Conclusion
GBS is a disease-causing peripheral neuropathy with no known etiology. It is a rare disease with relatively few case reports. Its incidence in endemic areas is unknown and difficult to establish even in high-income countries. Although GBS is an autoimmune process, its pathogenesis or the onset of inflammation has not been well studied. Despite active investigations aiming to find its cause, GBS remains a mystery and continues to be challenging for diagnosis and management.
It is still unclear what sets off the immune system reaction that leads to Guillain-Barre syndrome and whether certain factors make an individual more likely to develop it. There are likely many types of Guillain-Barre syndrome. More research is needed to understand the different forms and causes of Guillain-Barre syndrome!
References
https://www.medscape.com/answers/315632-14158/is-guillain-barre-syndrome-gbs-more-common-in-certain-age-groups#:~:text=GBS%20has%20been%20reported%20in,ages%2050%2D75%20y).
https://www.cdc.gov/campylobacter/guillain-barre.html
https://journalofethics.ama-assn.org/article/diagnosis-and-treatment-guillain-barre-syndrome/2007-08#:~:text=The%20clinical%20diagnosis%20of%20GBS,every%20case%20of%20suspected%20GBS.
https://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm
https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793
https://www.annalsofian.org/article.asp?issn=0972-2327;year=2011;volume=14;issue=5;spage=73;epage=81;aulast=Meena
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883091/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781841/
https://sfamjournals.onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2672.2001.01363.x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88896/
