The  disorder  called  Guillain-Barre  (ghee’-yan  bah-ray’)  syndrome,  or  GBS,  is  a  rare  illness typified  by the rapid onset of weakness,  often accompanied  and sometimes  even preceded by abnormal  sensations,  such  as  tingling  or  pain.  These  various  changes   reflect  damage  to peripheral nerves, that is, nerves located outside the brain and spinal cord. Peripheral nerves, discussed  in  more  detail  below,  include  motor  nerves  to  muscles  that  enable  movement, sensory  nerves from the skin and joints that detect texture,  limb position, etc.,and autonomic nerves that automatically regulate functions such as heart beat, blood pressure, pupil size, and a sense of bladder fullness. GBS can occur at any time without warning. It affects both genders and all age and ethnic groups. It varies greatly in severity from mild cases of brief weakness that may  not  even  come  to  a  doctor’s  attention,  to  a  devastating, life  threatening  illness  with complete paralysis,  respiratory failure  and inability to swallow. GBS is rare. Most people have never heard of it, or if they have, know little about it. The goal of this overview  is to acquaint the reader with the clinical features, causes, and treatments of GBS and variants, as well as the effect of these disorders  on the life of patients and their families.

HOW is GBS Diagnosed?

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.

Causes of GBS 

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.

Treatment

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