Types of Peripheral Neuropathy - Inflammatory

Idiopathic | Pre-diabetic/Diabetic | Hereditary | Toxic/Secondary to Drugs | Inflammatory | Systemic/Metabolic |
Compression | Other Types of PN

Guillain-Barré (ghee-yan bah-ray) syndrome (GBS) is a rare inflammatory disorder in which the body's immune system attacks the protective covering of the peripheral nerves (myelin sheath), preventing the nerves from sending signals to the muscles. It can develop over the course of several hours or days, or it may take up to 3 or 4 weeks. It is the most common cause of rapidly acquired paralysis and should be treated as a condition requiring urgent diagnosis and treatment.

The first symptoms of GBS usually include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations ascend and spread to the arms and upper body. Although many cases are mild, these symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In extreme cases, the patient has difficulty breathing and must be placed on a ventilator. If the throat and face are affected, a feeding tube may be required. In some cases, peripheral neuropathy may develop.

GBS improves spontaneously, but the recovery period may take from several weeks to more than a year. Most patients make a total recovery, from even the most severe cases of GBS, although some continue to have a certain degree of weakness, numbness or occasional pain.

Because of its sudden and unexpected onset, GBS can be a devastating disorder. It is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. No one yet knows why GBS strikes some people and not others, or what sets the disease in motion. There is no known cure for GBS, but therapies can lessen the severity of the illness and speed up recovery in most patients.

GBS can strike anyone, regardless of age or sex. GBS is not contagious, but it may follow a bacterial or viral infection, such as campylobacterial infection (caused by a bacteria found in undercooked food, especially poultry) or Epstein-Barr virus (EBV). Although GBS is not inherited, there may be a genetic predisposition to the disease. Some patients have a similar but longer-lasting illness called chronic inflammatory demyelinating polyneuropathy (CIDP). Once called 'chronic GBS,' CIDP is now considered a related, but distinct condition. GBS is also sometimes known as acute inflammatory demyelinating polyneuropathy (AIDP).

SYMPTOMS AND SIGNS

(Not all symptoms and signs may be present.)

• Acute or sub acute onset
• 50 - 60% of cases occur days or weeks after a viral or bacterial infection, such as a sore throat, the flu, or diarrhea.
• Surgery, childbirth or vaccinations may also trigger the syndrome
• Full recovery (even from extreme cases) probable for most patients
• Pain in spine and limbs
• Reflexes such as knee jerks are lost
• Weakness and tingling sensation in legs, possibly spreading to upper body and arms
• Weakness in breathing, swallowing and the muscles used to cough
• In extreme cases, paralysis

EVALUATION AND TESTS

(Not all evaluations and tests may be necessary.)

• Neurological exam
• Electromyography
• Nerve conduction velocity test
• Spinal tap (lumbar puncture)
• Blood tests

TREATMENT AND THERAPY

(Not all treatments and therapies may be indicated.)

• Intravenous immunoglobulin (IVIg)
• Plasmapheresis
• Pain medication
• Physical therapy
• Speech therapy if needed
• Ventilator, if needed
• Take safety measures to compensate for loss of sensation