Definition and causes og Guillain-Barré syndrome - GBS

Guillain-Barré syndrome (GBS) is a form of neuritis. The disease occurs in three out of four cases after an infection, for example, sore throat or stomach infection. It can also occur after an operation, after lymph cancer or borrelia.

The precise cause of the disease is unknown, but it is believed that antibodies formed against an invading virus for example a viral stomach infection afterwards attack the body's nerves. The reason is that some small parts of nerves resemble parts of the virus and the nerves are confused with an outside threat such as a virus or a bacterium to be killed. This is the most popular belief, but research is still ongoing in this area.

GBS is rare with about 1 new cases per year per in about 50.000 persons. All age groups are affected, and men and women affected equally frequently.

Symptoms of Guillain-Barré syndrome

Symptoms of GBS start within three weeks after the triggering event (usually infection):

• At first is experienced muscle pain and a feeling of the willies.
• Paralysis starting in the feet and legs spreads to arms, torso and face.
• Numbness and pain may accompany the paralysis
• Other signs such as blood pressure fluctuations, cardiac arrhythmias and dysuria (difficulties in passing urine)

Diagnosis of Guillain-Barré syndrome

The diagnosis involves electrical tests to measure nerve impulses and lumbar puncture to draw a cerebrospinal fluid sample for analysis.

Treatment of Guillain-Barré syndrome

Most patients recover fully with supportive treatment but in some the disease turns acute an it might be attempted to filter the blood, called plasmapheresis (to remove antibodies) or treatment with adrenal cortical hormones to dampen inflammation. Furthermore, respiratory therapy should always be on hand and treatment of fluctuating blood pressure and cardiac arrhythmias may be necessary. In the stage where the symptoms fade physiotherapy is the best treatment. In addition, supportive care and psychological support is important for the recovery phase.

Outlook

The symptoms worsen over the first few days up to four weeks at the most and recovery then sets in. During process the breathing muscles can be affected and respiratory assistance might be needed. As mentioned above most patients make a full recovery but some cases end fatally. Around 10% suffer permanent disability with weakness, others may have repeated attacks and some both permanent weakness and further attacks.

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