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Guillain–Barré Syndrome

Sunday, October 25th, 2009
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In January of 2009, my mom woke up suddenly at night and felt tingling, numbness, weakness, and other strange sensations in her legs and hands. Two days later she went to the ER, they refereed her to a neurologist who initially thought she may have Guillain-Barre Syndrome. Her sxs got worse for about three weeks- she could still walk, but it was a struggle to and she was in bed mostly for one month with weakness, strange sensations, tingling, muscle cramps, mostly in legs and hands, both sides. She had MRI, EMG, spinal tap. the only thing they saw was spinal tap elevated. they said she didn’t have MS> the Dr said she may never get a diagnosis. Now, ten months later, she is doing much better but still has a lot of tingling, vibrations, some weakness but no diagnosis. Has anyone heard of these sxs??

Answered by: Maria/MD Health Forum. com Team.

Guillain–Barré syndrome (GBS) is a rare disorder in which the body attacks its own nerve cells. The exact cause is unknown, but it in most cases, Guillain–Barré syndrome follows an infectious illness such as a respiratory infection or the stomach flu. Sometimes the syndrome occurs without any known triggers.

Our immune system normally attacks foreign body and invading organisms to prevent diseases. However, in GBS, the immune system attack the nerves that transmits signals between the body and the brain. The immune system particularly damages the nerves’ protective covering known as myelin sheath, causing a disruption in the signaling process and this leads to symptoms such as weakness, numbness or paralysis.

Guillain–Barré syndrome typically begins with weakness, tingling or loss of sensation starting in the feet and legs and spreading to the upper body and arms. These symptoms may begin in the fingers and toes. In some patients, symptoms begin in the arms or even the face. As the disorder progresses, muscle weakness can paralyze the whole body.

Because the symptoms of Guillain–Barré syndrome are similar to those of other neurological conditions, diagnosing the disorder during its initial stages could be a challenge. A spinal tap and nerve function tests are commonly requested to confirm diagnosis.

I’ve read that the distinct abnormality in people with GBS is elevated protein in the cerebrospinal fluid (CSF) with normal number of cells. The cerebrospinal fluid is the clear fluid that circulates through the ventricles of the brain, the the spinal cord and the subarachnoid spaces. The normal range of CSF protein in adults is 15- 60 mg for every 100 ml of fluid. The protein may be normal during the early stages of GBS, but it typically increases by the end of the first week. Aside from GBS, high protein in CSF is also found in infections, intracranial hemorrhages, multiple sclerosis, malignancies, some endocrine abnormalities, use of certain drugs medication use, and a variety of inflammatory conditions.

Nerve conduction study is important in evaluating nerve-related symptoms of patients with suspected GBS. This test will assess how nerves and muscles respond to small electrical stimuli. This is done by administering electrical shocks through the skin to activate the nerves. Damage to the nerves myelin sheath is evident when the conduction speed is not normal.

There is no known cure for Guillain-Barré syndrome, however, some therapies can lessen the severity of the illness and accelerate recovery in most patients. There are also a number of ways to treat the complications of the disease. Plasmapheresis and high-dose immunoglobulin therapy are currently used. Plasmapheresis seems to reduce the severity and duration of the Guillain-Barré episode. This treatment involves removing damaging antibodies from blood. High-dose immunoglobulin therapy is done by intravenous injections of healthy antibodies that will then block the damaging antibodies that may contribute to Guillain-Barré
syndrome.

Most people eventually fully recover from GBS, but some suffer from long-term disability or paralysis. Those who develop such complications are left with no choice but to adjust to limited mobility and must depend on others in carrying out activities of daily living.

Perhaps you should consider talking to your mom’s doctor and ask their opinion whether they think there is a need for further testing and what treatment options could they recommend.

This blog is for your general information only. I recommend that you discuss your mom’s symptoms with her health care provider.

References:
Guillain–Barré Syndrome: From Diagnosis to Recovery
Gareth J.Perry, Joel S. Steinberg 2007

http://www.aafp.org/afp/20040515/2405.html


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