Guillain-Barre syndrome GBS

What is Guillain-Barre Syndrome (GBS)?

Guillain-Barre Syndrome is a rare condition where the body’s immune system attacks the nerve tissue. It is an acute, progressive, autoimmune, inflammatory demyelination of peripheral sensory and motor nerves and nerve roots. GBS is the most common cause of acute non-trauma-related paralysis in the world. It is also the most common cause of acute motor paralysis in children.

What is its prevalence?

The annual incidence in the United States is 1.65 to 1.79 per 100,000 persons.1 Males are one and a half times more likely to be affected than females. No evidence exists for any racial predilection.

What are the triggering factors?

The exact cause is unknown. Two-thirds of patients report symptoms of viral or bacterial infections like Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumonia in the preceding 6 weeks. Vaccination against the flu, Rabies, meningitis is also the documented precipitating factors. It can also be seen in patients with lymphoma, HIV, SLE.

What are its subtypes?

There are 3 subtypes of Guillain-Barre syndrome:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): It is the most common form in the U.S. the most common sign of AIDP is muscle weakness that starts in the lower part of the body and spreads upwards.
  • Miller Fisher syndrome (MFS) in which the paralysis starts in the eyes. It is also associated with an unsteady gait. It occurs in about 5 percent of people with GBS in the U.S. but is more common in Asia.
  • Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN) which is less common in the U.S.

When to see a doctor?

The symptoms of Guillain-Barre syndrome are pain, progressive muscle weakness in the legs spreading to the upper body, tingling sensations, blood pressure instability, paresthesia (abnormal sensations in the skin), and muscle pain. There are also symptoms of muscle spasms, difficulty in eye movement, facial movement, speaking, chewing, or swallowing.

Weakness and tingling sensation in the fingers, toes, ankles, or wrists are usually the first symptoms. These sensations can quickly spread, eventually paralyzing the whole body. There is no history of fever at the onset of weakness.

What does a doctor see on physical examination?

Ascending motor weakness is noted along with areflexia is the classic form. Areflexia is a hallmark of GBS. Some of the proximal reflexes may still be elicited during the early phase of the disease. Documentation of the reflexes in serial examinations is of clinical value. Occasionally there may be autonomic instability (26%), ataxia (23%), dysesthesias (20%), cranial nerve findings (35-50%) predominantly facial nerve palsy are noted. Later, respiratory muscles and upper extremities show involvement.

Autonomic neuropathy manifests as orthostatic hypotension or hypertension, pupillary dysfunction, sweating abnormalities, and sinus tachycardia.

How does the doctor confirm the diagnosis?

After taking the history of symptoms and physical examination, certain tests can be done to confirm the diagnosis. These tests are:

  • Nerve conduction studies – electrodes are taped to the skin above the nerves under study. It shows a slowing or possible blockage of conduction
  • Spinal tap – a small amount of fluid is withdrawn from the spinal canal in the lower back. It shows increased protein levels but a normal white blood cell count.
  • Electromyography – thin needle electrodes are inserted into the muscles which the doctor wants to study. The electrodes measure nerve activity in the muscles.
  • Electrocardiogram, and
  • Pulmonary function test.

What are the treatment options available?

Following treatment options can speed up recovery and reduce the severity of illness:

  • Plasmapheresis – This treatment includes the exchanging of the plasma of the patient with the recovered patient or with that of normal people. This method improves short-term and long-term outcomes in the patients, as per various studies.
  • High dose intravenous Immunoglobulin therapy.
  • Mechanical ventilation may be required in severe cases until the respiratory muscle function returns to normal.
  • Pain control with non-steroidal anti-inflammatory drugs, carbamazepine, or gabapentin.
  • Supportive care – monitoring for respiratory and autonomic complications, prevention of venous thrombosis, skin breakdown, and deconditioning.

What can happen if I have GBS?2

People with Guillain-Barre Syndrome may develop complications like:

  • Pain
  • Thrombosis
  • The weakness of the respiratory muscles
  • Cardiac arrhythmias
  • Residual numbness or other sensations
  • Pressure sores
  • Bowel and bladder problems
  • Relapse: occurs in about 2-5% of cases

What is the disease course when it is left untreated?

Approximately 80% of the patients have a complete recovery. 3% of patients with GBS unfortunately may die. Neurologic problems persist in about 20% of patients, and one-half of these patients are severely disabled.1

Guillain-Barre syndrome GBS is a rare vaccine injury. Gold Law Firm, LLC. is the national vaccine injury law firm. Vaccine Law is all we do.

References

  1. AD W, G D. Guillain-Barré syndrome [Internet]. PubMed. 2021 [cited 1 March 2021]. Available from: https://pubmed.ncbi.nlm.nih.gov/23418763/#:~:text=Guillain%2DBarr%C3%A9%20syndrome%20consists%20of,to%201.79%20per%20100%2C000%20persons.
  2. Guillain-Barre syndrome – Symptoms and causes [Internet]. Mayo Clinic. 2021 [cited 1 March 2021]. Available from: https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793#:~:text=Guillain%2DBarre%20(gee%2DYAH,eventually%20paralyzing%20your%20whole%20body.

Guillain Barré Syndrome (GBS) is a disorder where a patient’s immune system begins to attack the peripheral nervous system. GBS can be triggered by vaccinations such as the influenza vaccine, tetanus shot, Hepatitis B vaccine, the Menactra® (MCV4) vaccine, the Gardasil® vaccine, and other vaccinations. The symptoms of Guillain Barre Syndrome typically start within one day to several weeks after a vaccination, but usually peaks around 2 weeks after the shot is given. However, medical literature suggests that patients are more susceptible up to ten (10) weeks after vaccination. Guillain Barre Syndrome can be generally described as a type of Peripheral Neuropathy. The chronic version of GBS is known as Chronic Inflammatory Demyelinating Polyneuropathy or CIDP.

The Influenza (flu shot) Vaccine

Your chances of getting Guillain Barré Syndrome after a flu shot are extremely low, but it’s not uncommon. Researchers who studied vaccine reaction rates found that “GBS is more strongly associated with vaccination for influenza” than for any other vaccine. The Journal of the American Medical Association cites Guillain Barré as the most frequent neurological condition reported after getting the flu shot. But the flu shot isn’t the only vaccine that may lead to GBS.

Gardasil® (HPV) Vaccine

There may be evidence that the Gardasil® vaccine, also known as the HPV (human papillomavirus) vaccination, can trigger Guillain Barré Syndrome. This vaccine is commonly given to prevent cervical cancer. The Centers for Disease Control reports that “Guillain Barré has been reported after vaccination with Gardasil®.” Other studies show that 72% of patients who reported GBS symptoms after a Gardasil® vaccine experienced those symptoms within 6 weeks after their shot.

What are the Symptoms of Guillain Barré Syndrome?

The first symptom of Guillain Barre Syndrome is often weakness or tingling in the legs. Those sensations can spread to the arms and upper body until the victim becomes paralyzed. GBS can cause such severe muscle weakness that patients must be put on a ventilator to breathe. Guillain Barre Syndrome is considered an autoimmune disorder because the body’s immune system attacks its own nervous system, damaging the coating around nerves.

Is It Possible To Completely Recover from GBS?

Complete recovery from Guillain Barre Syndrome does occur, but often it is a long and painful road of therapy and treatment. Unfortunately, some GBS patients end up with severe disabilities that will last throughout their lives. In rare cases, patients can die from GBS.

Types of Guillain Barré Variations

A number of different Guillain Barre Syndrome variants have been identified. Some of the most common are listed below:

  • Acute Inflammatory Demyelinating Polyneuropathy (AIDP)
  • Miller Fisher Syndrome (MFS)
  • Acute Motor Axonal Neuropathy (AMAN)
  • Acute Motor Sensory Axonal Neuropathy (AMSAN)
  • Pharyngeal-Cervical-Brachial Variant
  • Acute Panautonomic Neuropathy
  • Bickerstaff’s Brainstem Encephalitis (BBE)

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learn more at GBS-CIDP Foundation

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