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Guillain-Barre Syndrome
By peace | May 13, 2006
What is Guillain-Barre Syndrome?
Guillain-Barre(ghee-yan bah-ray) syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency.
Guillain-Barre syndrome is rare. It is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. Reflexes such as knee jerks are usually lost. Because the signals traveling along the nerve are slower, a nerve conduction velocity (NCV) test can give a doctor clues to aid the diagnosis. The cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual, so a physician may decide to perform a spinal tap.
GBS affects an estimated one to three in every 100,000 persons annually in the United States. It can strike any race at any age, but its incidence increases with age. GBS may occur within days or weeks after a viral infection such as influenza (flu) or diarrhea. It may be triggered by pregnancy or a medical procedure, such as a vaccination or minor surgery, or have no evident reason for developing. Because the cause of GBS is unknown, there’s no way to prevent the disease from occurring.
In its most severe form, GBS is a medical emergency and may require hospitalization. Severe GBS may result in total paralysis, potentially dangerous fluctuations in heart rate and blood pressure, and inability to breathe without respiratory assistance. The muscles you use for eye movement, speaking, chewing and swallowing also may become weak or paralyzed. People with severe GBS often need long-term rehabilitation to regain normal independence, and as many as 15 percent experience lasting physical impairment. In some cases, GBS can be fatal.
Most people recover from even the most severe cases of GBS. Available treatments, if started soon after signs and symptoms appear, may lessen the severity of GBS and reduce recovery time.
Causes
Doctors and scientists don’t know what causes Guillain-Barre syndrome. However, they believe that GBS is a disorder of the immune system. Research indicates that the immune system may destroy the protective covering of the peripheral nerves (myelin sheath), which disables the nerves from transmitting signals to the muscles. When this happens, muscles become unable to respond to nerve commands. Weakness, numbness or paralysis may occur. The brain also receives fewer sensory signals, resulting in the inability to feel heat, cold, pain and other sensations.
The most recognized conditions that occur before GBS develops are bacterial or viral infections. Approximately two-thirds of people affected by GBS have had a recent infectious illness, such as sore throat, diarrhea, cold or flu, within one to four weeks before the onset of GBS. The Epstein-Barr virus or Hodgkin’s disease also may precede GBS.
A bacterial infection such as campylobacteriosis — caused by campylobacter, bacteria commonly found in undercooked food, especially poultry — may be a possible cause of GBS. This form of the disorder is usually more severe because it directly attacks the nerves, instead of the nerve coverings.
GBS may also be triggered by medical procedures including surgery and, in rare cases, influenza immunizations. However, the connection between the flu vaccine and GBS is weak, and the risk the vaccine poses to your health is much less significant than your risk of serious flu-related illness.
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