Quite often, the patient’s symptoms and physical exam are sufficient to indicate the diagnosis. The rapid onset of (ascending) weakness, frequently accompanied by abnormal sensations that affect both sides of the body similarly, is a common presenting picture. Losses of reflexes, such as the knee jerk are usually found. To confirm the diagnosis, a lumbar puncture to find elevated fluid protein and electrical tests of nerve and muscle function may be performed.
The cause of GBS is not known. Perhaps 50% of cases occur shortly after a viral or bacterial infection such as a sore throat or diarrhea. Many cases developed in people who received the 1976 swine flu vaccine. Current theories suggest an auto-immune mechanism, in which the patient’s defense system of antibodies and white blood cells are triggered into damaging the nerve covering or insulation, leading to weakness and abnormal sensations.
Because progression of the GBS disease in its early stages is un-predictable, most newly diagnosed patients are hospitalized, and usually placed in an intensive care unit to monitor breathing and other body functions.
Care involves use of general supportive measures for the paralyzed patient, and also methods specifically designed to speed recovery, especially for those patients with major problems, such as inability to walk. Plasma exchange (a blood “cleansing” procedure) and high dose intravenous immune globulins are often helpful to shorten the course of GBS.
Most patients, after their early hospital stay and when medically stable, are candidates for a rehabilitation program to help regain muscle strength as nerve supply returns