What Is A Guillain Barre Syndrome?
It is defined as a disorder in which there is a problem in the auto immune system. It is also known as the GBS. In this there is an acute inflammation of the de myelinating poly neuropathy. It is known as the AIDP. It involves the peripheral nervous system which starts by the process of acute infection. It was described in the year 1916 by the French physicians such as strohl and Guillian. It is also known as the landrys paralysis. It comes under the peripheral neuropathies. AIDP is the most common form of this syndrome. It hardly involves 1 to 2 people per 1 lakh people. One can treat is with the help of plasmapheresis as well as the use of immune globins intravenously. Most of the patients have a full function capacity. In case if there are complications in the lung it may lead to death. It may also occur if there is an involvement of autonomic nervous system. This condition leads to paralysis by the weakness seen in case of legs and it spreads to the upper parts of body. The reflexes are also lost completely in later cases. It is one of the common causes of non trauma paralysis.
What are the signs and symptoms of Guillain Barre Syndrome?
It includes the paralysis by the weakness seen in case of legs and it spreads to the upper parts of body. The reflexes are also lost completely in later cases. There is a weakness in both the sides of body. They have rubbery legs which tend to buckle and may or may not show the numbness. The weakness moves from upwards and remains there for extended period of time. It also involves the arms as well as face. It can also involve the cranial nerves which may lead to the difficulty in swallowing as well as the maintenance of open air way. It may also lead to the problem in respiration. The patient must be kept in hospital and he must be given ventilator help. This Disorder hardly involves the eyes and in severe cases bladder is involved. One can also feel the involvement of spinal cord. Sometimes the pain can be treated with the help of analgesics. There can be no position sense or the loss of deep tendon reflexes. The loss of temperature sensation is not that much. There is a deep aching pain in which there is a weak muscle as compared to the over exercise. One can also suspect a severe spinal cord problem. Fever is not so common. In few cases there is a loss of autonomic function in which there is a problem in blood pressure, hypo tension as well as the orthostatic hypotension. The acute paralysis in this syndrome is linked to the blockage of sodium channel in the cerebero spinal fluid. One must also keep a check on the salt as well as water content. This problem resembles to that of the inflammation of nerves.
What are the causes of Guillain Barre Syndrome?
It includes the immune response to antigens which are not properly targeted. The target can be the gangliosides which are present in the nerves of human. The most common infecting type of bacteria is C Jejuni. In most of the cases the cause is not known. A few cases can occur due to the influenza virus or by the immune reaction. It involves the peripheral nerves along with a myelin which is a sheath which protects the nerves.
How Guillain Barre Syndrome can be diagnosed?
It includes the use of visual examination and a patient history. It can be required or supportive. It depends on the weakness of muscles as well as other signs and symptoms such as the absence of fever etc. There are few tests of muscles as well as nerves which must be done so that the electro diagnostic tests and cerebero fluid analysis can be done. It is done by the lumbar spinal puncture and nerve conduction studies. The required diagnostic criterion includes the course which is less than 4 weeks. There is a weakness of the limbs of both the sides which occurs due to the neuropathy. There is a reflexia. The supportive diagnosis includes the numbness as well as symmetric weakness. There is no fever and cranial nerve is involved too. The lumbar puncture tells us about the CSF findings and there is a loss of myelin from the electro myogram.
How Guillain Barre Syndrome can be treated?
One can treat is with the help of plasmapheresis as well as the use of immune globins intravenously. Most of the patients have a full function capacity. In case if there are complications in the lung it may lead to death. One must go for a supportive care and monitor all the vital functions. One must keep a check on the respiratory failure and there must be an early intubation. One can see paralysis of the diaphragm. Intubation must be done in those cases where the disease progresses very rapidly. Treatment must be started as early as possible; one can give plasma pheresis or the intra venous use of immune globins alone or in combination. Intra venous immune globins are easy to give and are quite safe. But in some cases it can lead o hepatitis or kidney failure. The use of gluco corticoids have been not much effective and the use of plasmapheresis is done with the help of a plasma exchange which is done many times a week.
After an acute phase there is a need of rehabilitation so that the lost functions can be regained. The activities of daily life are improved like the washing, brushing as well as getting properly dressed. There must be a team of therapists as well as the nurses. It works as per the patient needs. There is an occupation therapist who needs the wheel chair as well as special cutlery. One must also consult a physio therapist so that he can plan the progressive training programme and can guide the patient to correct the movement which is functional. One must prevent the harmful compensations. One must also consult a speech as well as language therapist. One can also go for the tracheotomy. This therapist can offer advice to the medical team in relation to the swallowing abilities. The patient is able to communicate. One can also need a doctor as well as a nurse. The patient must function at home after the process of rehabilitation.