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Guillain-Barre Disease
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Guillain-Barre syndrome is not very common. It occurs when the body's immune system turns on the nerves and leads to weakness and numbness in the arms and legs, progressing to include paralysis of the entire body. No one knows the exact cause of Guillain-Barre disease but they know it is something like a respiratory infection or the stomach flu. In rare cases, vaccinations have been known to cause the disease to occur. It affects about 1-2 out of every 100,000 individuals.
When it is most severe, Guillain-Barre disease causes a medical emergency that needs hospitalization. There is no obvious cure for the disease. Nevertheless, most people recover without complication.
The symptoms of Guillain-Barre disease begin with a gradual weakness, loss of sensation or tingling of the feet and legs. It spreads upward to include the trunk and the upper extremities. In other people, the symptoms can begin in the arms or in the face. Paralysis can become part of the problem so the patient can't move or breathe on their own.
The main symptoms include:
- Pins and needles sensation in your fingers, toes or perhaps both.
- Weakness of the legs that spreads upwards
- Inability to walk or walking unsteadily.
- Problems swallowing, chewing, speaking or facial movements
- Severe lower back pain
- Difficulty with bowel movements or urinary abilities
- Low blood pressure or slow heart rate
- Breathing difficulties
Weakness is most profound around three weeks after the symptoms first begin. It can also progress to severe symptoms within hours of having the onset of symptoms. You should see the doctor if you have ascending paralysis or tingling, rapidly spreading tingling, tingling that affects the feet and hands both or difficulty breathing. If you are choking on your saliva, you should definitely seek immediate attention. Hospitalization is important because the disease can progress rapidly and without warning.
The real cause of Guillain Barre is not known. It is preceded by an infection in 60 percent of cases. No one knows why some people get the disease and why some people don't get it. Often, there are no triggers.
In Guillain Barre syndrome, your immune system appears to attack nervous tissue, particularly the myelin sheath, so that peripheral nerves don't work very well and the nerves become tingling and eventually paralytic.
Risk factors for Guillain Barre Syndrome include being a young adult and being an older adult. Triggers for the disease include having recent surgery, the Epstein Barre Virus infection, having Hodgkin's disease, having mononucleosis, having an HIV infection or having immunizations against rabies or the influenza vaccination.
It is a difficult disease to detect, especially when the condition is early. It can act like other neurological and muscular diseases. A careful history and physical exam can determine whether or not the disease is Guillain Barre Syndrome. A spinal tap can help confirm the diagnosis of the disease. This involves taking a small amount of spinal fluid from the back and examining it for changes typical for Guillain Barre disease.
There are two nerve function tests that can help identify the Guillain Barre disease. These include an electromyogram, which tests for muscle and nerve functioning in various parts of the body. Nerve conduction studies tell how the nerves function when responding to small electrical stimuli.
Most cases of the disease worsen over two week's time. Symptoms will reach a certain plateau and will remain the same for about two to four weeks. It takes about 6-12 months for the disease to go away. While there is no cure, plasmapheresis can help get rid of the antibodies that cause the disease. IV immunoglobulin can be done to replace bad antibodies with healthy antibodies so that the disease is kept in check while the patient recovers. There is usually no overlap between the two treatments.