Guillain-Barre Syndrome

Guillain-Barre Syndrome (GBS)/Acute inflammatory demyelinating polyneuropathy

Acute onset severe progressive symmetrical inflammatory polyneuropathy; (Pronounced “ghee-lain” or “ge-yan”); in 70% – develops 1-4 weeks after respiratory infection or diarrhea. More common <30 years. Incidence of 1-2/100 000/year.

Pathologically – considered an autoimmune response to viral infection  multifocal inflammatory segmental demyelination

Clinical features:
History of viral respiratory or gastrointestinal infection (usually clears before onset of neurological symptoms). Rapidly progressive ascending symmetric muscle weakness (progresses to paralysis) – usually starts in lower limbs with numbness or tingling  then upper. Typically develops over a few days; Maximum weakness after about 3 to 4 weeks. Distal pain and parathesia (feet and hands) may precede weakness. No or mild sensory loss. Reflexes lost (normal for first few days). Muscles may be painful on palpation. 20-30% develop respiratory weakness – can develop very rapidly. CSF protein is increased from, usually, 2nd week.

Four clinical variants generally recognised – Ascending GBS; Descending GBS; Miller-Fisher variant (may not be a form of GBS, but is related to brain stem encephalitis); and pure motor GBS

Differential diagnosis – poliomyelitis, botulism, heavy metal poisoning, polymyositis

Treatment:
Most need hospitalisation. Respiratory function monitoring  often needs intubation and ventilatory support; prevention of DVT; Plasma exchanges helpful if given early; intravenous immunoglobulin; Steroids are not indicated; Physiotherapy and occupational therapy for rehabilitation
3-6% have a relapse or second episode

Guillain-Barré Syndrome and COVID-19 Infection and Vaccination:
There has been some commentary in social media that the COVID-19 vaccines can cause Guillain-Barré Syndrome. The actual evidence indicates that a COVID-19 infection increases the risk for GBS and that the vaccines are protective.

We have not yet got to this page. We will eventually. Please contact us if you have something to contribute to it or sign up for our newsletter or like us on Facebook and Instagram or follow us on Twitter.

Page last updated: @ 9:31 pm