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Guillain-Barré Disease and Therapy Options
Guillain-Barre syndrome (GBS) is an uncommon condition in which the immune system targets the nerves in the body leading to muscle weakness, tingling in the extremities, and sometimes paralysis. GBS is a rare disease that affects roughly 1 in 1000 persons (Centers for Disease Control and Prevention (CDC)). According to CDC, between 3,000 and 6,000 persons in the US contract GBS each year. GBS can affect anyone; however, it is more frequent in men and individuals aged 50 and above.
Almost all occurrences of GBS are sporadic, meaning they occur in persons with no family history of the disease. There have been a few households with more than one affected member; nonetheless, the ailment does not have a definite genetic pattern. The chromosome 17p11 mutation has been linked to severe GBS (Khanmohammadi et al.). According to Khanmohammadi et al., several genes are associated with GBS occurrence, although the results are still controversial. Multiple persons in the same lineage have been documented to have GBS on rare occasions. Generally, these cases are caused by relatives sharing normal variations in particular genes, which may enhance the likelihood of developing GBS.
Tingling and numbness in the feet and legs are common symptoms of GBS, which can progress to the upper body and arms. The typical GBS patient most often manifests as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), which appears with finger dysesthesias and proximal muscle weakness in the lower extremities 2-4 weeks after a relatively mild infection (Andary). According to the CDC, the symptoms may spread over hours or days, affecting the arms, nerves, and breathing muscles, with exhaustion peaking in the first two weeks after symptoms. Overall, the signs may worsen to the point that some muscles cannot be used, and the individual could become paralyzed in severe conditions.
The bodys immune system primarily attacks a component of the peripheral nervous system in GBS. The symptoms can spread to the nerves that control muscular action and those that convey pain, heat, and touch sensations. Muscle weakness and lack of feeling in the legs and arms may follow. Other body processes affected by GBS include breathing, eating, and speaking. Respiratory dysfunction occurs when GBS spreads to the chest muscles, making breathing hard. Up to one-third of patients experience respiratory failure and require breathing support at some point throughout their illness (Andary). In severe forms of GBS, the ability to swallow and speak may be impaired. According to Andary, even in better healthcare settings, 3-5% of GBS patients die due to paralysis of the respiratory muscles, blood infection, pulmonary clots, or cardiogenic shock. Generally, GBS is a life-threatening situation, and those who are ill should be considered critical and treated immediately.
The first therapy option is admitting the patient into the intensive care unit (ICU) for cardiac and infection monitoring. Plasma exchange, which extracts and replenishes the liquid part of the blood, and high-dose immunoglobulin therapy (an antibody infusion) are two common treatments (CDC). Patients may need rehabilitation therapy (speech, physical, and occupational) to restore their muscles and regain movement if the condition persists after the acute phase of the illness.
In brief, GBS is an autoimmune disease that attacks the myelin of a persons peripheral nerves. The condition causes muscular weakness, speech and vision impairment, and discomfort. Multiple environmental and genetic variables are thought to play a role in developing this disease. However, inheriting a mutated gene associated with GBS does not guarantee that a person will acquire the syndrome. Treatment is crucial and should include monitoring respiration, cardiac function, and infection. Finally, rehabilitative therapy can follow if the condition persists after medical interventions.
Works Cited
Andary, Michael T. Guillain-Barre Syndrome. Medscape, 2021.
Centers for Disease Control and Prevention (CDC). Guillain-Barré Syndrome. 2019.
Khanmohammadi, Shaghayegh, et al. Genetic basis of Guillain-Barre syndrome. Journal of Neuroimmunology, vol. 358, 2021.
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