Guillain-Barre Syndrome Nathan McNeil, MD 4/15/2010
History • 1859, Landry published a report on 10 patients with an ascending paralysis • Subsequently, in 1916, 3 French physicians (Guillain, Barré, and Strohl) described 2 French soldiers with motor weakness, areflexia, CSF albuminocytological dissociation, and diminished deep tendon reflexes.
Guillain-BarréSyndrome (GBS) • GBS is a heterogeneous grouping of immune-mediated processes generally characterized by motor, sensory, and autonomic dysfunction • GBS is an acute inflammatory demyelinatingpolyneuropathy • Symptoms • Progressive symmetric ascending muscle weakness • Paralysis • Decreased reflexes
Causes • Generally preceded by a bacterial or viral infection • Bacterial diarrhea is frequently with Campylobacter jejuni. • It’s believed that the body’s immune system creates antibodies to fight the infection that also recognize and attack the nerves—specifically Schwann cells.
Course • Most patients (up to 85%) with GBS achieve a full and functional recovery within 6-12 months. • Recovery is maximal by 18 months • Approximately 7-15% of patients have permanent neurologic sequelae including bilateral footdrop, intrinsic hand muscle wasting, sensory ataxia, and dysesthesia.
Treatment • Only plasma exchange (PE) therapy and intravenous immune serum globulin (IVIG) have proven effective for Guillain-Barré syndrome (GBS). • Both have been shown to shorten recovery time by as much as 50%