Guillain-Barré syndrome is an attack of the peripheral nerves, the channels transmitting information from the central nervous system (brain and spinal cord) to the muscles and organs. It results in muscle weakness or progressive paralysis most often in the legs, although it can also affect the hands, feet as well as limbs. These symptoms usually last between six months and one year. Guillain-Barré syndrome is also called inflammatory acute polyradiculoneuropathy. It often follows a viral or bacterial infection.
Individuals ranging from any age can be affected by Guillain-Barré syndrome. However, the chances of developing it increase with age. Guillain-Barré syndrome is a treatable condition and, although some cases can cause long-term complications, patients suffering from the condition usually make a full recovery.
The symptoms of Guillain-Barré syndrome appear suddenly and can be of varying intensity depending on the case. They evolve in three distinct phases.
- Extension phase: The first symptom to appear is a tingling sensation in the feet and hands. This is followed by muscle weakness that can lead to paralysis. It usually starts from the legs (or feet) and then progressively moves up the body, causing respiratory paralysis, facial or swallowing muscles. This phase can happen over a period of one week to one month and may require emergency management in case of respiratory blockage or swallowing.
- Plateau phase: The symptoms of Guillain-Barré syndrome stabilize. However, there are some continuing symptoms such as hypertension, hypotension, tachycardia or complications such as the appearance of pressure ulcers, blood clots (phlebitis) or urinary tract infections. The duration of this second phase is very variable, ranging from a few days to several months.
- Recovery phase: This is the last phase of the Guillain-Barré syndrome, during which the symptoms gradually decline. This lasts for several months.
Peripheral nerves consist of nerve fibres that are surrounded by an insulating sheath called myelin. This is what allows a good circulation of nervous information. In the case of Guillain-Barré syndrome, this myelin is deteriorated or destroyed. This is called demyelination. Guillain-Barré syndrome is an autoimmune disease. That is, it is the immune system that turns against the body. Harmful antibodies are produced and will attack myelin. The reason for this is not known. However, it often follows a viral or bacterial infection, such as angina, influenza or more recently, Zika fever.
Other triggers may include:
- food poisoning
- cytomegalovirus (harmless virus that usually doesn't cause symptoms)
- Vaccination (extremely rare cases)
- Medical procedure or surgery
Guillain-Barré syndrome should be treated as quickly as possible to avoid too much damage to the nerves. There are two main treatments depending on the severity of the disease: either by intravenous immunoglobulin injections (healthy antibodies that will destroy the harmful antibodies), or by plasmapheresis, a technique of replacing the blood plasma with healthy plasma. In case of respiratory paralysis, respiratory assistance is essential. In case of serious swallowing disorder, patients are fed with a gastric tube. Once Guillain-Barré syndrome is cured, it rarely has any lasting effects. The relapse rate is also very low.