What is Guillain Barre Syndrome – diagnosis & treatment

What is Guillain barre syndrome?

Guillain barre syndrome is an autoimmune disorder of the lower motor neuron. The Immune system starts damaging nerves. Neurons that control muscle movements are affected. The motor and sensory neurons are affected. So, the muscle weakness, paralysis and a sensation loss occur. The immune system starts attacking the peripheral nervous system. The brain is intact only peripheral nerve is affected.

Click the image below to get detailed information on Spinal muscular atrophy or SMA

Pathology of Guillain barre syndrome:

There are two types of the GBS depending upon the time of an onset. Acute which take 10-12 days to show symptoms. A sudden GBS which starts suddenly. Like a patient might complain that last night I was completely well and in the morning I was unable to rise. If all four limbs are involved it is called a global Paralysis.

Bacteria enter a human body and release chemicals which are similar to chemicals on the myelin sheath. Immune system considers the myelin sheath as a foreign body and attacks the myelin sheath. And covering disappear from nerve. Signal from brain is disrupted.

Causes of GBS:

In GBS patients symptoms for the bacterial or viral infection is same. A Recovery stage identifies the cause. Though the particular cause is unknown some common causes are enlisted below:

  • Idiopathic (Cause unknown)
  • Campylobacter bacteria found in uncooked poultry
  • Influenza virus
  • Zika Virus
  • Hepatitis A, B, C, E
  • HIV virus
  • Mycoplasma pneumonia
  • Cytomegalovirus
  • Sensory and motor neuron damage

Symptoms of Guillain barre syndrome:

  • Muscle cramps
  • Muscle atrophy
  • Difficult swallowing
  • Abnormal heart beat
  • Co-ordination problems
  • Sensation loss
  • Tingling or burning pain at night

Pattern of GBS:

The Progressive weakness start from proximal muscles. Legs are more affected than arm. The weakness or paralysis moves from proximal end to distal end.

Diagnosis of Guillain barre syndrome:

  • Deep tendon reflexes in legs are lost
  • Reflexes might also be absent in arms.
  • Nerve conduction velocity test
  • CSF analysis
  • Lumbar puncture
  • Absent myotatic reflexes
  • Nerve conduction study
  • Blood test is performed to identify ANTIBODY responsible for it.

Treatment for Guillain barre syndrome:

Myelin sheath is affected. The coating of myelin sheath is damaged. Schwann’s cells are responsible for the formation of the myelin sheath. To repair myelin sheath proliferation of Schwann cells occur. Recovery depends upon the severity.

Medications:

  • Intravenous immunoglobulin to suppress immunity
  • Steroids for quick & temporary relief by suppressing symptoms.
  • Steroids for quick & temporary relief by suppressing symptoms.
  • Multi-vitamins and supplements.
  • Plasma replacement

Physical therapy:

  • Ask the day of onset
  • Analyze severity
  • Passive ROM all 4 limbs
  • Balancing ball
Guillain barre syndrome
  • Sensations test
  • Thermoregulation disturbed and patient is unaware but bed sores might form.
  • Change bed positioning after every 2 hours.
  • Stair climbing
  • Active ROM (All 4 limbs)
  • Resisted exercises for strengthening.
  • Quadriplegic chair
  • Rightening reaction (Disturb patients balance & ask him to maintain his balance
  • Bobath technique (Compression and cross compression)

Nerve Stimulation:

TENS is prescribed to prevent muscle atrophy and to produce contractions. Heat modalities are prevented as sensations are lost. So, increased heat can cause skin burns but the patient would be unaware of it. Sweating a mechanism is disturbed. So avoid using heating modalities in Guillain barre syndrome.

PNF techniques to initiate movements

Guillain barre syndrome

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