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April 12, 2008 at 8:08 am #6508
Apr 12, 2008
Guillain-Barre syndrome (GBS) – Definition, Causes, Symptoms and Treatment
Guillain-Barrй Syndrome called is acute inflammatory demyelinating polyneuropathy and Landry’s ascending paralysis. It is a an inflammatory disorder of the peripheral nerves and autoimmune disorder. Its frequency is about 1 to 2 cases in every 100,000 people per year in the United States. Men and women, but it occurs most often in young and the elderly.Guillain-Barre syndrome may be an autoimmune disorder in which the body produces antibodies that damage the myelin sheath that surrounds peripheral nerves. The myelin sheath is a fatty substance that surrounds axons. It increases the speed at which signals travel along the nerves. The disorder is characterised by progressive symmetrical paralysis and loss of reflexes, usually beginning in the legs. Perhaps 50% of cases occur shortly after a microbial (viral or bacterial) infection such as a sore throat or diarrhea. An autoimmune mechanism, in which the patient’s defense system of antibodies and white blood cells are triggered into damaging the nerve covering or insulation, leading to weakness and abnormal sensation.
GBS commences with progressive muscular weakness of extremities that may lead to paralysis. It spreads rapidly, ascending to involve the cranial nerves. Guillain-Barre syndrome may occur in association with viral infections like glandular fever, AIDS, and herpes simplex or after infections with bacteria. Most people with Guillain-Barre syndrome experience their most significant weakness within three weeks after symptoms begin. The symptoms are not always the same in every person, but typically reflexes will be lost and the paralysis or loss of feeling will occur on both sides of the body rather than just one side or the other. About one quarter of the time, the paralysis continues up the chest and freezes the breathing muscles, leaving the patient dependent on a ventilator. If the swallowing muscles are also affected, a feeding tube may be needed. In some cases, signs and symptoms may progress very rapidly with complete paralysis of legs, arms and breathing muscles over the course of a few hours.
Symptoms of this phase, causing only mild difficulty in walking, requiring crutches or a walking stick. Supportive care with monitoring of all vital functions is the cornerstone of successful management in the acute patient. Plasmapheresis. This treatment — also known as plasma exchange — is a type of “blood cleansing” in which damaging antibodies are removed from your blood. Plasmapheresis consists of removing the liquid portion of your blood (plasma) and separating it from the actual blood cells. Additional treatments are directed at prevention of complications such as choking during feeding (through positioning or use of a nasogastric feeding tube), blood clots (through mobilising the patient and sometimes the use of drugs to thin the blood ), intermittent bladder catheterization, and effective treatment of pain. Intravenous immunoglobulin. Immunoglobulin contains healthy antibodies from blood donors. High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.
Treatment for Guillain-Barre syndrome (GBS) Tips
1. Plasmapheresis and high-dose immunoglobulin therapy are used.
2. Supportive care with monitoring of all vital functions is the cornerstone of successful management in the acute patient.
3. Immunoglobulin contains healthy antibodies from blood donors.
4. Intravenous immune globulin (IVIg) is equally effective in reducing the severity and duration of the symptoms.
5. Use of steroid hormones has also been tried as a way to reduce the severity of Guillain-Barre.
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