What is Guillain-Barre Syndrome (GBS) – Causes, Symptoms, and Treatment

Guillain-Barre Syndrome is a rare condition where your immune system attacks your nerves. Thus causing a tingling sensation in various parts of your body. In some serious cases, this syndrome can turn muscle weakness into paralysis. GBS can affect people of all ages and demographics but is more common in adults and males. 

To learn more about what Guillain-Barre Syndrome is, along with its symptoms, causes, and treatment, please keep reading.

Guillain-Barre Syndrome, or GBS, is an acute disorder in which the immune system attacks part of the peripheral nervous system. Therefore, it often causes a paralytic condition, loss of certain sensations such as touch, pain, and heat. Furthermore, it affects muscle control and movements.

There are mainly four variants of Guillain-Barre Syndrome, namely:

1. Acute Inflammatory Demyelinating Polyneuropathy (AIDP)

Acute inflammatory demyelinating polyneuropathy (AIDP) is characterised by progressive weakness along with mild changes in sensory neurons. These are often followed by motor weakness and, in some rare cases, respiratory failure.

AIDP is the most prevailing type of GBS in Europe and North America. Some of its common indications include weakness of muscles starting from the lower end of the body and spreading upwards.

2. Miller-Fisher Syndrome (MFS)

Miller-Fisher Syndrome, or MFS, is one of the rarest variants of Guillain-Barre Syndrome. Unlike AIDP, this variant affects the upper end of the body first and gradually spreads downwards. Moreover, it involves the cranial nerves, weakening the muscle that controls eye movement and others, including those for balance and coordination.

This type of GBS is of rare prevalence in western countries and occurs more commonly in Asian countries like Japan and Taiwan.

3. Acute Motor Axonal Neuropathy (AMAN)

This type of GBS is more frequent in Japan, China and Mexico. Here, the immune system attacks the axons of the motor neurons.

In acute motor axonal neuropathy, the degeneration of motor neurons may cause motor weakness, areflexia, ataxia and acute paralysis.

4. Acute Motor-Sensory Axonal Neuropathy (AMSAN)

AMSAN is another paralytic disorder like AMAN. However, in this variant, the sensory nerves are also affected along with motor nerves.

It is characterised by the onset of sensory impairments such as the inability to sense the position of limbs, progressive distal weakness, and loss of tendon reflexes. AMSAN is more prevalent in Asia and Latin America.

The symptoms of GBS are progressive in nature. Once started, they begin to spread rapidly. Here are 13 Guillain-Barre Syndrome symptoms:

• Pins-and-needles or tingling prickly sensations in toes, ankles, fingers, and wrists
• Weakness, starting in the legs and spreading upwards
• Numbness, especially in distal muscles
• Paralysis
• Loss of coordination and muscle control
• Problems in facial and throat movement, including difficulty in speaking, breathing, chewing or swallowing
• Inability to empty the bladder and bowel
• Loss of tendon reflexes
• Imbalance, or difficulty in walking or climbing
• Severe pain that may be persistent
• Blurry or double vision
• Rapid heart rate
• Unnatural rise or fall of blood pressure

According to experts Guillain-Barre Syndrome occurs when your body’s immune system attacks the nerves instead of providing a defence against germs and infections. This is a classic example of an autoimmune condition, which means that the immune system attacks one’s own body tissues. 

The exact cause behind this syndrome is unknown but there are certain possible triggers. Two of them are:

Infections

It is seen that in most cases GBS develops after a few days and sometimes weeks after an infection. The list below highlights the common infections that can lead to Guillain-Barre Syndrome:

• Food poisoning
• Flu
• HIV
• Cytomegalovirus
• Tropical diseases like dengue or Zika virus
• Glandular Fever

Vaccination

Previously, vaccination for flu was associated with the developing cause of Guillain-Barre Syndrome. However, later research proved the chances of developing GBS after the vaccination is very rare.

Although the exact reason behind the onset of this condition is unknown, most people who develop GBS experience a bacterial or viral infection shortly earlier.

The risk factors for Guillain-Barre Syndrome are as follows:

1. Demographic Factors:

• Gender: Both males and females can be affected by GBS. However, males are more prone to develop it.
• Age: GBS can affect people of all age groups, but the risk increases with age. It is more frequent in adults and older males, particularly those above 50 years.

2. Health and Medical Factors

Guillain-Barre is most commonly associated with bacterial and viral infections. According to various studies, people who experience the following infections earlier may have a higher risk of developing GBS:

• Campylobacter jejuni infection: It is the most common risk factor triggered by Campylobacter bacteria and characterised by diarrhoea. It is caused by undercooked food, particularly poultry.
• Influenza virus infection
• Epstein-Barr virus infection
• Zika virus infection
• HIV or people suffering from AIDS
• COVID-19 virus
• Cytomegalovirus infection
• Hepatitis A, B, C and E
• Mycoplasma pneumonia
• Surgery
• Immediately after trauma, such as a road accident 
• Hodgkin's lymphoma
• In rare cases, vaccinations given in childhood

Guillain-Barre Syndrome diagnosis can be problematic in the early stages, as its symptoms clash with other common neurological disorders. 

Nonetheless, the three most common methods include the following

• Spinal tap method: It is also known as lumbar puncture. Here, a small amount of fluid is withdrawn from the spinal canal in the lower back. It aims to analyse the presence of increased protein WBC, which indicates GBS.
• Electromyography: This test is used to measure the electrical activity in the muscle fibres. Here, needle electrodes are inserted in the muscle through the skin to measure neuromuscular abnormalities, such as improper conduction of nerve signals. 
• Nerve conduction velocity test: In this test, the electrodes are placed on the skin above the peripheral nerves. It measures the speed at which nerves transmit signals by sending small shock impulses through the electrodes.

Guillain-Barre Syndrome has no permanent cure. However, the symptoms and severity can be treated or reduced.

In most cases, the symptoms start to stabilise and fade on their own after a few weeks or months. Rare conditions require hospitalisation and supportive care such as breathing assistance.

The two common treatments that aim to minimise the severity include:

• Plasmapheresis or Plasma exchange: It is a process where first the blood is removed. Then the plasma carrying the autoimmune-causing antibodies is filtered out. The blood is then returned to the body, which carries less dis-functioning antibodies so that fresh plasma is manufactured and restored by the body.
• Intravenous immunoglobulin (IVIG): Here, immunoglobulin with healthy antibodies are extracted from donors and then injected intravenously into the recipients. This can help to block the antibodies that cause GBS.

Other than these, medications can be given in the case of:

• Severe pain
• Blood clot due to immobility

In addition, some people may require additional help with the movement of limbs and walk. It includes physical training, physiotherapy, etc.

It can be emotionally challenging to cope if you are diagnosed with Guillain-Barre Syndrome. Although you can fully recover with support and treatment, managing stress during the ailment period is also important.

Therefore, you can follow the following three steps to manage GBS:

• Reach out: You should reach out to your friends and family for support during difficult times to get adequate mental and emotional support. You can also contact a counsellor or look for support groups online. This can help you share your feelings and concerns.
• Prepare for the doctor’s appointment: If you are advised or feel it necessary to consult a doctor, you can do the following things:
  • Note down your symptoms
  • List down your medications and if you have suffered any bacterial or viral infection or any other condition recently.
  • Note the queries you have for the doctor.
  • Ask a friend or companion to accompany you for emotional support and to note the important things.
• Communicate with your doctor: Ask your doctor the necessary questions, such as the type of tests you need, the necessary treatments, time to recover, long-term complications, etc., so that you can plan ahead. Ensure that you do not hold back questions or doubts to receive total support and treatment.

Now that you have a clear idea about what Guillain-Barre Syndrome is, along with its symptoms and causes, it will help you identify the condition faster. Therefore, as soon as you notice any of the signs and symptoms, consult a professional immediately.