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Alternative namesLandry-Guillain-Barre syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy
DefinitionGuillain-Barre syndrome is a disorder caused by nerve inflammation involving progressive muscle weakness or paralysis , which often follows an infectious illness.
Causes, incidence, and risk factors
Guillain-Barre syndrome is an acute type of nerve inflammation. The inflammation damages portions of the nerve cell, resulting in muscle weakness or paralysis and sensory loss. The damage usually includes loss of the myelin sheath of the nerve (demyelination ), which slows the conduction of impulses through the nerve.
The damage can also cause denervation (kill the axon part of the nerve cell), which stops nerve function entirely. Without the axon, messages cannot be transferred from one nerve cell to another.
The disorder progresses rapidly (from days to a few weeks), causing w eakness or paralysis in a symmetrical manner. As weakness starts in the legs and then spreads to the arms, it is referred to as ascending paralysis. At the same time, patients may notice tingling, foot or hand pain, and clumsiness. As paralysis worsens, the patient may require assisted ventilation in order to breathe.
Signs and tests
A history of increasing muscle weakness and paralysis may indicate Guillain-Barre syndrome, especially if there was a recent illness.
Neurological examination shows muscle weakness and may indicate dysfunction of the control of involuntary (autonomic) body functions such as blood pressure and heart rate. Sensory loss may be minimal, even when sensory changes are present.
There may be evidence of decreased breathing ability caused by paralysis of the breathing muscles and a decrease in deep tendon reflexes in the arms and legs.
TreatmentIn the past, before treatment was available, many patients recovered completely with time. However, symptoms may be severe during the course of the disorder, and hospitalization is usually required to support breathing function and prevent complications and to provide physical therapy.
Plasmaphoresis may decrease the severity of the symptoms and facilitate a more rapid recovery. In this procedure, blood plasma, which contains antibodies , is removed from the body and replaced with intravenous fluids or antibody-free donated plasma. Intravenous immune globulin (IVIg) is equally effective in reducing the severity and duration of the symptoms.
Other treatments are directed at preventing complications such as choking during feeding (through positioning or use of a feeding tube), blood clots (through positioning and sometimes blood thinners), intermittent bladder catheterization, and others. Pain is treated aggressively with anti-inflammatory agents and narcotics if needed.
Guillain-Barre Syndrome Foundation International
Expectations (prognosis)Almost all cases (95%) survive and the majority recover completely. Mild weakness may persist for some people. The outcome is most likely to be very good when symptoms remit within 3 weeks of their onset.
Calling your health care providerGo to the emergency room or call the local emergency number (such as 911) if loss of movement , decreased sensation or other emergency symptoms occur, including difficulty swallowing or breathing, feeling "unable to take a deep breath," or fainting .
Update Date: 7/17/2002Joseph V. Campellone, M.D., Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT