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Guillain-Barre syndrome – Symptoms & Diagnosis
By peace | May 14, 2006
GBS is a serious disease that requires immediate hospitalization because of the rapid rate at which it worsens. Early treatment is important. The sooner appropriate treatment is started, the better the chance of a good outcome. If treatment can result in reducing the inflammation of your peripheral nerves, the chances of serious permanent damage to the myelin sheath and nerve fibers may be substantially decreased.
If you experience a tingling sensation in your toes, feet or legs followed by muscle weakness, seek medical attention immediately. Failure to see your doctor promptly may lead to progression of the disorder and paralysis, which can leave you incapacitated and unable to get help.
Signs and Symptoms
The signs and symptoms of GBS usually appear rapidly over the course of a single day. These may include:
- Weakness, tingling or loss of sensation that often begins in your feet and legs and spreads to your upper body and arms
- Moderate pain throughout your body
- Difficulty breathing
- Paralysis of your legs, arms, respiratory muscles and face
- Difficulty with eye movement, facial movement, speaking, chewing or swallowing
- Very slow heart rate or low blood pressure
- Difficulty with bladder control or intestinal functions
GBS progresses quickly, with most people experiencing the most significant weakness in the legs, arms, chest and other areas within three weeks of the start of this disorder. In some cases, the signs and symptoms of GBS may progress very rapidly with complete paralysis of legs, arms and breathing muscles over the course of a few hours.
If GBS is mild, the signs and symptoms may not extend beyond a feeling of general weakness. GBS may improve on its own within a few weeks, and some people initially may think the signs and symptoms are due simply to a common virus.
The signs and symptoms of GBS may last days, weeks or months before muscle sensation begins to return. Regaining your pre-illness strength and functioning is slow, sometimes requiring months or years. However, most people with GBS return to normal within months.
Screening and Diagnosis
GBS can be difficult to diagnose in its earliest stages. Its signs and symptoms are similar to those of other neurological disorders and may vary from person to person.
The first step in diagnosing GBS is for your doctor to take a careful medical history to fully understand the cluster of signs and symptoms that you’re experiencing. People with GBS have a relatively sudden onset of signs and symptoms, and muscle weakness usually occurs on both sides of the body as opposed to on one side only, as in a stroke.
Doctors commonly use two tests to determine if GBS is present:
- Electromyography (EMG). An EMG helps establish a diagnosis and the extent of a neurological problem by measuring the electrical activity of a muscle in response to nerve stimulation. The test also measures the nature and speed of impulse conduction along a nerve. In an EMG, a technician inserts electrodes in fine needles into the muscles being tested and places electrodes on your skin over peripheral nerves.
- Spinal tap (lumbar puncture). This procedure involves inserting a needle into your spinal canal, usually at the low back (lumbar) level. Your doctor can determine the pressure of the cerebrospinal fluid (CSF), and a sample of fluid can be removed for laboratory analysis. This analysis may include checking for evidence of bleeding, the number and types of white blood cells, the levels of glucose and protein, the types of proteins, and tests for bacteria and fungi.
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