Early symptoms of Guillain-Barré syndrome
The early symptoms of Guillain-Barré (GBS) syndrome usually are tingling and weakness in the feet and legs that vary and intensity and may spread to the upper body and arms.
Guillain-Barré syndrome symptoms include:
· Prickling in the fingers, toes, ankles or wrists.
· Weakness in the legs that radiates to the upper body.
· Unsteady gait or inability to walk or climb stairs.
· Difficulty with eye or facial movements, such as speaking, chewing or swallowing.
· Severe pain that may feel achy or cramp-like and may worsen at night.
· Difficulty with bladder control or bowel function.
· Rapid heart rate.
· Low or high blood pressure.
· Difficulty breathing.
GBS is a rare medical disorder (affecting 1-2 people in every 100,000) named after the French neurologists Georges Guillain and Jean Alexandre Barré who described it in 1916 – along with André Strohl who probably knew better than to be forever thought of in connection with a neurological disease. This is an autoimmune disease; that is, the patient’s own immune system damages parts of the peripheral nervous system outside the brain and spinal cord as if they were foreign cells. It is not known why the immune system turns on the body and starts attacking instead of protecting in GBS, but researchers have been able to observe certain relationships. For instance, more than 50% of cases of Guillain-Barré syndrome follow viral or bacterial respiratory or digestive tract infections by a few days or weeks. Other risk factors for GBS include:
· Infection with a type of bacteria often found in undercooked poultry called campylobacter.
· Influenza virus.
· Epstein-Barr virus.
· HIV, the virus that causes AIDS.
· Mycoplasma pneumonia.
· Hodgkin's lymphoma.
Very rarely, influenza and childhood vaccinations might trigger Guillain-Barré syndrome, but it’s still better to take that risk than to go without immunization. Scientists do not know either why GBS affects some persons and not others, but the fact remains that anyone can develop this disorder regardless of age and sex – though men and older adults have a higher risk. Recently, a link between a mosquito-borne virus called Zika and the onset of Guillain-Barré syndrome has been strongly suspected by CDC, the WHO, and other health organisms, due to a concomitance of the viral infection and GBS during a Zika outbreak in the Americas. Therefore, the Zika virus – and travel to affected countries – might be added to the list of risk factors until further notice.
Serious complications of GBS may appear as quickly as weeks, days, and even hours after the early symptoms of Guillain-Barré syndrome occur. The nerves that GBS affects are the same that convey the message when the brain tells the muscles to move. The ensuing communication breakdown can lead to muscle paralysis that can make breathing and swallowing difficult, and require hospitalization – sometimes in an intensive care unit. Other complications include the following:
· About 30% of patients have residual weakness or numbness after 3 years.
· Blood pressure fluctuations.
· Irregular heart rhythms.
· Nerve pain.
· Sluggish bowel function.
· Urine retention.
· Blood clots.
· Up to 5% of patients experience a relapse.
Guillain-Barré syndrome symptoms resemble those of other conditions, so a doctor will ask questions and perform tests to rule out other disorders and confirm a diagnosis of GBS. The most commonly used tests are:
· Spinal tap.
· Electromyogram (EMG).
· Nerve conduction velocity (NCV) test
The bad news is that no cure has been developed for Guillain-Barré syndrome. The good news is that the condition is temporary. The worse news is that its effects can be devastating and the speed of recovery is inversely proportional to the suddenness of the disorder’s onset. However, two specific treatments can decrease the severity of GBS and accelerate recovery.
Guillain-Barré syndrome treatment and recovery
Plasma exchange (plasmapheresis).
· Movement of arms and legs by caregivers before recovery, to help keep muscles flexible and strong.
· Physical therapy during recovery to help regain strength and proper movement.
· Training with medical supplies such as a wheelchair or braces, to provide mobility and self-care skills.
· Exercise therapy to cope with fatigue.
· The condition tends to progressively become worse for about 2 weeks after the first symptoms.
· Symptoms level off within 4 weeks.
· Recovery lasts between 6 and 12 months, although some people may take up to 3 years.
· About 80% of adults can walk independently 6 months after diagnosis.
· About 60% of adults fully recover motor strength 1 year after diagnosis.
· About 5 -10% of adults experience delayed and incomplete recovery.
The doctor may also prescribe medications for pain. Not unsurprisingly, children – who seldom have GBS – recover more swiftly than adults. In addition to physical impediments, Guillain-Barré syndrome patients encounter emotional issues. They are advised to take comfort in family and friends, join a support group, and talk about their feelings with a professional counselor.