How is Guillain Barre Syndrome Detected?

Guillain Barre Syndrome, commonly called GBS, is an autoimmune condition that can worsen rapidly. The first symptoms usually include Weakness and tingling in your extremities.

These sensations can spread quickly and paralyzing your whole body eventually. Guillain-Barre syndrome, in its most severe form, is a medical emergency. Many people with the condition must be hospitalized to receive treatment.

What is Guillain Barre Syndrome?

In the autoimmune disease of GBS, the target cells are nerves. An autoimmune disease is a condition in which your body’s immune system accidentally attacks healthy cells. GBS is often activated by an acute viral or bacterial infection. This condition requires immediate attention.

What are the types of Guillain Barre Syndrome?

There are four types of the syndrome:

• Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP). This type is characterized by muscle pain in your lower body, which slowly progresses upwards. It is the most common type of GBS, especially among the populations of Europe and North America.
• Miller Fisher Syndrome (MFS). This type is characterized by paralysis that begins in the eyes. You may also experience an unsteady gait. This condition is more prevalent in Asian countries.
• Acute Motor Axonal Neuropathy (AMAN). This type is characterized by acute paralysis and a loss of reflex. However, there is no sensory loss associated with this condition. This type commonly occurs in Mexico, China, and Japan.
• Acute Motor-Sensory Axonal Neuropathy (AMSAN). This variant of GBS is rare and severe. An affected individual may take a very long time to recover from this type.

What are the symptoms of Guillain Barre Syndrome?

The following are the symptoms of GBS:

• A tingling sensation in your feet, hands, toes, and fingers.
• Paralysis in one or many parts of the body.
• Muscle weakness that initially presents in your lower body and gradually spreads upwards.
• Difficulty in moving facial muscles, making it hard to speak, chew, and swallow.
• Impairment in eye movements and clear vision.
• Inability to walk steadily.
• Increased heart rate and blood pressure.
• Pain in the lower back.
• Loss of bladder control.
• Suffocation.
• Severe pain, especially at night.

When should I visit a doctor?

Guillain Barre Syndrome is a very serious condition that can worsen rapidly. The sooner you start treatment, the better the chance of recovering. Seek medical attention immediately if you notice any of the following symptoms:

• Tingling and weakness that is spreading rapidly across your body
• Shortness of breath when you are lying flat
• Choking on your saliva.
• Trouble catching your breath.

Request an appointment at Apollo Hospitals.

Call 1860-500-1066 to book an appointment.

How is Guillain Barre Syndrome diagnosed?

GBS is diagnosed based on key findings such as:

• Rapid development of muscle paralysis.
• Absent reflexes.
• Inability to explain unusual sensations and pain in your body.
• Diminished deep tendon reflexes in weak limbs. Deep tendon reflex is a repetitive contraction of the muscle in response to tendon stretch.
• Elevated cerebrospinal fluid protein without an increase in cell count. (Cerebrospinal fluid is a clear fluid present in the brain and spinal cord.)
• Abnormal nerve conduction velocity.

The diagnostic tests performed for GBS are given below:

Cerebrospinal fluid analysis or spinal tap.

In this test, a small quantity of cerebrospinal fluid is extracted by a procedure called a lumbar puncture or spinal tap. The fluid is removed by inserting a needle between the lumbar vertebrae. Characteristic findings of GBS with this test are an elevated protein level (greater than 0.55g/L) and a low white-blood cell count (fewer than 10 WBCs per cubic millimeter of fluid).

Neurophysiology.

The neurophysiology of a patient is assessed by performing electromyography and nerve conduction tests. This can help eliminate many other conditions and distinguish the variants of GBS.

• Electromyography. This is a nerve function test that reads the electrical activity of your muscles. These readings can help your doctor figure out if your muscle weakness is a result of muscle damage or nerve damage.
• Nerve conduction tests. This test is used to test the response of your nerves and muscles to small electric pulses.

Blood tests.

In certain cases, blood tests helps in finding the antibody responsible. For instance, the Miller-Fisher variant of Guillain-Barré is generally associated with an antibody known as GQ1b. Finding this antibody confirms the diagnosis of Miller-Fisher variant, and can make the doctor especially cautious about a future requirement for intubation.

Magnetic Resonance Imaging (MRI).

MRI of the spinal cord is performed to distinguish GBS from other conditions that can cause limb weakness. A characteristic finding of GBS is  enhanced nerve roots. However, this is not specific to GBS, and so a confirmation test may be required.

What are the risk factors for GBS?

The following are some of the risk factors for Guillain Barre Syndrome:

• Health conditions such as AIDS, mycoplasma pneumonia, Covid-19, Hodgkin’s lymphoma, and infection with campylobacter, hepatitis, influenza, etc.
• Trauma.
• Surgery.
• Childhood vaccinations.

How is GBS treated?

Guillain Barre Syndrome is generally treated with immunotherapy. There are two types of immunotherapy procedures used in GBS treatment. They are:

• Plasmapheresis (plasma exchange). Plasma, the liquid portion of part of your blood, is removed and separated from the blood cells. Then, blood cells are put back into the body, which manufactures more plasma to makeup for what was taken out. Plasmapheresis works by ridding plasma of certain antibodies which contribute to the attack of the immune system on the peripheral nerves.
•    Intravenous immunoglobulin. High doses of immunoglobulin (containing a donor’s healthy antibodies) are administered to block out the faulty antibodies produced by your immune system.

What are the complications of GBS?

As GBS affects an important organ system in your body, that is, the nervous system, it can lead to several complications. Some of them are:

• Breathing difficulties. This is a likely fatal complication. A small percentage of patients require the assistance of a machine to breathe properly.
• Residual numbness. Depending on the progression and severity of your condition, you may be left with residual numbness.
• Blood pressure and heart issues.
• Bladder and bowel problems. Urine retention and sluggish bowel movements  might occur in GBS patients.
• Blood clots. If you are unable to walk properly, you may be required to take blood thinners as blood clots are a potential complication.
• Pressure sores. GBS may cause pressure sores. This complication can be easily eliminated by changing your position frequently.
• Relapse.

Conclusion

Guillain Barre Syndrome can be diagnosed and treated effectively, provided you seek immediate medical attention when you notice unusual symptoms. As it is a severe condition, ensure that you do not underestimate the symptoms.

Frequently Asked Questions (FAQs)

1. What happens in Guillain Barre Syndrome?

In GBS, the immune system destroys the myelin sheath (the protective covering of a neuron) of your peripheral nerves. This impairs your nerve cells’ ability to transmit signals. This, in turn, affects your muscles’ response to the brain’s commands, resulting in muscle wastage and weakness. As your nerves are damaged, your sensory functions are also affected, causing unexplained tingling in your hands and feet. 

2. What are the causes of Guillain Barre Syndrome?

The exact cause of GBS is unknown. The condition usually occurs weeks after a digestive or respiratory disorder and/or a viral or bacterial infection. Guillain Barre Syndrome is a result of the malfunctioning of the immune system, which attacks the peripheral nervous system, thereby causing muscle atrophy, paralysis, and seizures. GBS is not contagious or genetic.

3. What should I expect after treatment?

After treatment, it may take you a while to get back to normal. For a limited period, you may have to use a wheelchair or a walker to get around. To recover quickly, you can try physical therapy to build your strength. While most people recover fully, some may be left with permanent nerve damage.