Diagnoses & Conditions

Guillain-Barré Syndrome (GBS)

Understanding GBS

Guillain-Barré syndrome (GBS) is rare and believed to be an autoimmune disorder. An autoimmune disorder develops when the immune system malfunctions and creates antibodies that attack and cause damage to a part of the body. In GBS, the myelin sheath is attacked. The myelin sheath is the protective covering over nerves, which aids in transmitting nerve signals from spine to muscles. This attack on the myelin sheath results in muscle weakness and abnormal, or loss of, sensation such as numbness and/or tingling. GBS can range from mild with brief weakness to paralysis of breathing muscles, an emergency situation. Most GBS patients recover even from the most severe cases. After recovery, some patients will continue to have some degree of weakness. GBS usually occurs following a respiratory or gastrointestinal infection.

Symptoms of GBS

Symptoms of Guillain-Barré syndrome (GBS) include weakness usually beginning in the legs and then arms. There may be numbness or tingling starting in the feet or hands (stocking-glove pattern) and then traveling upward. The symptoms start and progress quickly over days or weeks. Because the progression can ultimately affect breathing muscles, most people are diagnosed in the hospital and may even end up in the ICU on mechanical ventilation before a definitive diagnosis is made.

Diagnosing GBS

Diagnosing Guillain-Barré syndrome (GBS) can be difficult as the signs and symptoms are similar to other neurological disorders. The presenting symptoms and the sudden onset may lead a physician to suspect GBS.

Diagnostic testing may include:

  • Thorough neurological exam to assess for weakness, sensory changes and loss of reflexes.
  • Medical history including any recent bacterial or viral infections.
  • Electromyography (EMG) to measure muscle activity.
  • Nerve conduction studies (NCS) to measure efficiency and speed of nerve signals.
  • Lumbar puncture to assess the spinal fluid for indicators of GBS, or for other disorders which may cause similar symptoms.

Treating GBS

Guillain-Barré syndrome (GBS) may be treated with immune globulin therapy administered into the blood stream intravenously (IVIG) or plasmapheresis. Plasmapheresis (also known as apheresis, plasma exchange, or “plex”) is a medical procedure where a device separates whole blood into the cellular components and plasma. The plasma is then discarded and replaced with a colloid fluid, combined back with the cellular components, and returned to the same patient. IVIG or plasmapheresis is then followed by physical rehabilitation. The goal of IVIG or plasmapheresis in GBS is to stop the attack on the myelin sheath, which will result in improvement of symptoms. Treatment usually consists of only one or two courses of therapy. Because GBS occurs rapidly, there can be extensive loss of function before treatment starts. The rehabilitation process can take weeks to years. About one-third of people affected by GBS will have some residual weakness after three years. A very small percentage may experience a recurrence.



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