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Guillain-Barre' Syndrome - Symptoms
Guillain-Barre' syndrome (GBS) is also known as acute demyelinating polyneuropathy because of its adverse effect on myelin, a sheath that protects normal nerve tissue.
This acute illness is frequently severe and fulminant and occurs at a rate of one case per million population per month. This represents approximately 3,500 cases per year in the United States and Canada. In over two-thirds of cases GBS a viral infection precedes the onset of the disease by 1-3 weeks.
Herpes infections, cytomegalovirus, or Epstein-Barr virus (causative agent in mononucleosis) account for a large percentage of viral-triggered cases. Approximately 5-10% of GBS cases can occur within 1-4 weeks of a surgical procedure or associated with lymphoma, Hodgkin's disease, or systemic lupus erythematosus. GBS is thought to be somehow immune-mediated but the exact pathogenesis of the disease remains unknown.
Symptoms of GBS
The signs and symptoms of GBS include absent reflexes and progressive limb paralysis. There may also be some mild disturbances in sensation. Eventual involvement of the respiratory muscles is also seen.
Most patients with GBS will require hospitalization and about one-quarter will require respiratory support on a mechanical ventilator. The prognosis is good with approximately 85% of patients making a complete recovery. The mortality rate is 3-4%. Management is largely supportive, but a technique of filtering the blood known as plasmapheresis has shown to be effective. Treatment with steroids has been used in the past but a beneficial role has yet to be proven.
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