GUILLAIN-BARRE SYNDROME

Nathan McNeil, MD4/15/2010

History

1859, Landry published a report on 10 patients with an ascending paralysis

Subsequently, in 1916, 3 French physicians (Guillain, Barré, and Strohl) described 2 French soldiers with motor weakness, areflexia, CSF albuminocytological dissociation, and diminished deep tendon reflexes.

Guillain-Barré Syndrome (GBS)

GBS is a heterogeneous grouping of immune-mediated processes generally characterized by motor, sensory, and autonomic dysfunction

GBS is an acute inflammatory demyelinating polyneuropathy

Symptoms Progressive symmetric ascending muscle

weakness Paralysis Decreased reflexes

Causes

Generally preceded by a bacterial or viral infection

Bacterial diarrhea is frequently with Campylobacter jejuni.

It’s believed that the body’s immune system creates antibodies to fight the infection that also recognize and attack the nerves—specifically Schwann cells.

Course

Most patients (up to 85%) with GBS achieve a full and functional recovery within 6-12 months.

Recovery is maximal by 18 months Approximately 7-15% of patients have

permanent neurologic sequelae including bilateral footdrop, intrinsic hand muscle wasting, sensory ataxia, and dysesthesia.

Treatment

Only plasma exchange (PE) therapy and intravenous immune serum globulin (IVIG) have proven effective for Guillain-Barré syndrome (GBS).

Both have been shown to shorten recovery time by as much as 50%