Guillain-Barre Syndrome

Guillain-Barré syndrome is fortunately a relatively rare inflammatory disease that affects the nervous system, especially peripheral nerves coming from the spinal cord. It belongs among the so-called polyneuropathies. The symptoms of this condition can be quite dramatic and sometimes they even threaten the patient's life. Fortunately, the disease tends spontaneously to retreat in many cases.


The causes of Guillain-Barré syndrome are not entirely clear. Its occurrence may be preceded by physical or psychological stress, followed by a viral infection. This infection somehow causes the immune system to target the body own nerve fibers and their sheaths. From this perspective, therefore, Guillain-Barré syndrome can be classified as a form of autoimmune disease.


Damage of the peripheral nerves results in heavy loss of their function. The affected person loses mobility and sensation in the affected region. The disease tends to progress upwards. Paralysis of the lower extremities spreads to the trunk and it heads ever higher. The patient may become paralyzed on all four limbs, but before that happens, the paralysis of diaphragm and intercostal muscles (major breathing muscles) may cause suffocation. However, with modern therapeutic methods, it is possible to keep the patient alive at this stage and when this is successful; the further prognosis is relatively well.


The patient should undergo cautious neurological examination that demonstrates progressive symmetrical paralysis of the muscles. Electromyography proves the failure of conduction of nerve impulses. Other important diagnostic method is lumbar puncture. The puncture shows significant increase of protein concentration, but normal number of white blood cells in the liquor. This finding is referred to as protein-cytological dissociation.


The treatment usually includes special "blood cleansing" with a special machine. This process is known as plasmapheresis. Plasmapheresis can eliminate the autoantibodies attacking the patient's own tissues. In addition to plasmapheresis, application of large doses of immunoglobulins has shown a considerable effect.


Further therapy focuses on supporting the respiratory muscles to keep the patient alive - acute situation may be solved by artificial lung ventilation.


The symptoms begin to disappear within weeks and in many people, the situation may return to normal without any consequences. However, permanent disability may sometimes persist.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources