Guillain–Barré syndrome

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Guillain–Barré syndrome
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Muscle weakness, paresthesia, autonomic dysfunction
Complications	N/A
Onset	Rapid, over hours to weeks
Duration	Weeks to months
Types	N/A
Causes	Often follows infection (e.g., Campylobacter jejuni, Cytomegalovirus, Epstein–Barr virus)
Risks	Recent infection, surgery, vaccination
Diagnosis	Clinical examination, nerve conduction study, cerebrospinal fluid analysis
Differential diagnosis	Chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, botulism
Prevention	N/A
Treatment	Intravenous immunoglobulin, plasmapheresis, supportive care
Medication	N/A
Prognosis	Variable; most recover fully, some have residual weakness
Frequency	1-2 per 100,000 per year
Deaths	4-7% mortality rate

Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. The initial symptoms are typically changes in sensation or pain along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body, with both sides being involved. The symptoms develop over hours to a few weeks. During the acute phase, the disorder can be life-threatening, with about 15% developing weakness of the breathing muscles and therefore requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.

Causes

GBS is believed to be triggered by an infection. The diagnosis is usually made based on the symptoms and physical examination, although nerve conduction studies and lumbar puncture (to look for elevated protein levels in the cerebrospinal fluid) can provide supportive evidence. The underlying mechanism involves the body's immune system mistakenly attacking the peripheral nerves and damaging their myelin insulation. Sometimes, this immune dysfunction is triggered by an infection.

Treatment

The most commonly used treatments are intravenous immunoglobulins (IVIG) and plasmapheresis. IVIG is usually the first line of treatment, followed by plasmapheresis if IVIG is not effective. Steroids have also been tried, but they have not been found to be effective. The disorder can cause long-term problems, with about a third having some degree of weakness after a year, and about a fifth having a long-term disability. With good care, death is uncommon.

Gallery

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  Campylobacter jejuni, a common trigger of Guillain–Barré syndrome

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  Nerve damage in Guillain–Barré syndrome

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  Georges Guillain, after whom the syndrome is named

See also

• Peripheral nervous system
• Intravenous immunoglobulins
• Plasmapheresis
• Steroids

References

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