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Treatment of Guillain-Barre syndrome
By peace | May 15, 2006
Guillain-Barre syndrome can be a devastating disorder because of its sudden and unexpected onset. Most people reach the stage of greatest weakness within the first 2 weeks after symptoms appear, and by the third week of the illness 90 percent of all patients are at their weakest. The recovery period may be as little as a few weeks or as long as a few years. About 30 percent of those with Guillain-Barré still have a residual weakness after 3 years. About 3 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.
Depending on the severity of GBS, self-care may be limited until the recovery process has begun. Once the crisis phase is over and rehabilitation starts, work closely with your doctor and rehabilitation team to ensure the best possible outcome. Although it’s often difficult and sometimes painful, try to be as cooperative as possible during physical therapy and other demanding rehabilitation activities. Know that your hard work, dedication and perseverance will pay off with the regaining of your mobility and independence.
Treatment
There’s no cure for GBS. However, certain therapies can lessen the severity of the illness and accelerate recovery for most people. The general treatment for GBS is supportive care to help with activities of daily living, such as eating and using the bathroom. For some, recovery can take a long time — from several months to a year or more.
According to a guideline developed by the American Academy of Neurology (AAN), treating GBS early, within two to four weeks after signs and symptoms first appear, may speed recovery time. Two main treatments, both equally effective, have been shown to speed the recovery from and reduce the severity of GBS in adults:
- Plasmapheresis (plaz-muh-fuh-RE-sis). This treatment — also known as plasma exchange — is a type of “blood cleansing” in which damaging antibodies are removed from your blood. Plasmapheresis consists of removing the liquid portion of your blood (plasma) and separating it from the actual blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. It’s not clear why this treatment works, but scientists believe that plasmapheresis removes certain antibodies from plasma that contribute to the immune system attack on the peripheral nerves.
- Intravenous immunoglobulin (IVIg). Immunoglobulin contains healthy antibodies from blood donors. High doses of immunoglobulin can block the damaging antibodies in your blood that may contribute to GBS.
The AAN guideline also shows no benefit in combining plasma exchange and IVIg. Mixing the treatments or administering one after the other is no more effective than if either method is used alone.
Your treatment also may include pain medications including acetaminophen and nonsteroidal anti-inflammatory drugs, possibly in combination with narcotic painkillers.
Often before recovery begins, caregivers may need to manually move your arms and legs to help keep your muscles flexible and strong. After recovery has begun, you’ll likely need physical therapy to help regain strength and proper movement to be able to function on your own. Whirlpool therapy (hydrotherapy) may help relieve pain and retrain the movement of your affected limbs. After your symptoms subside, your rehabilitation team will prescribe an active exercise routine to help you regain muscle strength and independence. You may need training with adaptive devices, such as a wheelchair or braces, to give you mobility and self-care skills.
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