Guillain-Barré syndrome is a rare disorder

Guillain-Barré syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body.

1. Guillain-Barre Syndrome Dr. Ahmed Rizvee, MBBS, CMU, MCGP (MEDICINE)

2. Nomenclature: Guillain-Barré syndrome is  named after the two French neurologists who first described it in 1916. Georges Guillain and Jean Alexandre Barré .

3. How Pronounced ?? gee- yan bar-ray

4. INTRODUCTION: Guillain-Barré syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body.

5. DEFINITION : Guillain-Barré syndrome is a rare but serious autoimmune disorder in which the immune system attacks healthy nerve cells in your peripheral nervous system (PNS).

6. TYPES: 1. Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP): The most common sign of AIDP is muscle weakness that starts in the lower part of your body and spreads upward. 2. Miller Fisher Syndrome (MFS): In MFS paralysis starts in the eyes. MFS is also associated with unsteady gait. 3. Acute Motor Axonal Neuropathy (AMAN) 4. Acute motor-sensory axonal neuropathy (AMSAN)

7. RISK FACTORS: Most commonly, infection with campylobacter , a type of bacteria found in undercooked poultry Influenza virus Hepatitis A , B , C and E HIV , the virus that causes AIDS Mycoplasma pneumonia Surgery Hodgkin's lymphoma Rarely, influenza vaccinations or childhood vaccinations

8. CAUSES: The exact cause of Guillain-Barre syndrome is unknown . The disorder usually appears days or weeks after a respiratory or digestive tract infection. Rarely, recent surgery or immunization can trigger Guillain- Barre syndrome. Recently, there have been a few cases reported following infection with the Zika virus .

9. SYMPTOMS: Prickling , pins and needles sensations in the fingers, toes, ankles or wrists Weakness in your legs that spreads to your upper body Unsteady walking or inability to walk or climb stairs Difficulty with eye or facial movements , including speaking, chewing or swallowing Severe pain that may feel achy or cramp like and may be worse at night Difficulty with bladder control or bowel function Rapid heart rate Low or high blood pressure Difficulty breathing

10. DIAGNOSIS: Spinal Tap (lumbar puncture): A small amount of fluid is withdrawn from the spinal canal in your lower back. The fluid is tested for a type of change that commonly occurs in people who have Guillain-Barre syndrome. Electromyography: Thin-needle electrodes are inserted into the muscles your doctor wants to study. The electrodes measure nerve activity in the muscles. Nerve conduction studies. Electrodes are taped to the skin above your nerves. A small shock is passed through the nerve to measure the speed of nerve signals.

11. COMPLICATIONS: Guillain-Barre syndrome affects the nerves. Because nerves control the movements and respiration, there will be b reathing difficulties . Residual numbness or other sensations: Most people with Guillain- Barre syndrome recover completely or have only minor, residual weakness, numbness or tingling. Heart and blood pressure problems: Blood pressure fluctuations and irregular heart rhythms (cardiac arrhythmias) are common side effects of Guillain-Barre syndrome Pain: Up to half of people with Guillain-Barre syndrome experience severe nerve pain, which may be eased with medication. Bowel and bladder function problems: Sluggish bowel function and urine retention may result from Guillain-Barre syndrome.

12. Cont. Blood clots: People who are immobile due to Guillain-Barre syndrome are at risk of developing blood clots. Until you're able to walk independently, taking blood thinners and wearing support stockings may be recommended. Pressure sores: Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem. Relapse: Around 3 percent of people with Guillain-Barre syndrome experience a relapse.

13. TREATMENT : There's no cure for Guillain-Barre syndrome. But two types of treatments can speedup recovery and reduce the severity of the illness. Plasma exchange (plasmapheresis): The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves. Immunoglobulin therapy: Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.

14. Steroids Not Recommended In The Treatment Of GBS.

15. Reference: 1. European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome. 2. The American Academy of Neurology (AAN) guideline on Guillain-Barré Syndrome (GBS).

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