Download Guillain-Barré Syndrome

Guillain-Barré Syndrome
What is Guillain-Barré syndrome (GBS)?
'Guillain-Barré syndrome' (pronounced Ghee-yan
Bar-ray), or GBS, is a disorder in which the body’s
immune system attacks the nerves that carry the
signals between your body and your brain. The
nerves’ protective covering (myelin sheath) is
damaged. The nerves in the arms and legs become
inflamed and stop working. This causes muscle
weakness and limb paralysis. As well, patients may
lose feeling in their arms and legs; sometimes with
pain.
Who can get GBS?
Anyone around the world – young or old, male or
female – can get GBS. The illness is not hereditary.
In Canada, GBS affects about one in 50,000 people.
Although many illnesses or other events seem to
trigger Guillain-Barré syndrome, why the disorder
occurs in certain people is still not known.
Is GBS contagious?
No, GBS is not contagious. However, because
Guillain-Barré syndrome often follows a viral or
bacterial illness, it is sometimes mistakenly thought
to be contagious.
In fact, there is no evidence that GBS is passed
from person to person. Often the virus or bacteria
that caused the initial illness is no longer present
when the syndrome appears.
Can vaccines cause GBS?
What causes GBS?
The cause of Guillain-Barré syndrome is not
known. Scientists believe that the body’s immune
system begins to attack the body itself, causing
what is known as an autoimmune disorder. A
number of different events seem to trigger the
illness.
Between 50% and 60% of cases occur a few days to
a few weeks after an infection. These infections
include the common cold, sore throat, infectious
mononucleosis, and viral hepatitis. GBS may also
follow infections with stomach and intestinal
viruses or bacteria that cause vomiting and diarrhea.
Others cases of GBS have occurred with a rare
disease of red blood cells called porphyria. Some
cases have occurred after such seemingly unrelated
events such as surgery, insect stings and various
injections, including vaccines.
In 1976, GBS was found to occur somewhat more
often after influenza vaccine than usual (about 10
extra cases of GBS per million doses of the vaccine
given in 1976 – 1977). Since then, the risk of GBS
occurring after influenza vaccine has been
determined to be about one case of GBS per million
doses of vaccine given.
Experts around the world agree that the risk of
serious and deadly illness from influenza is far
greater than the risk of GBS.
In the same way that GBS may follow a natural
infection, rare cases of Guillain-Barré syndrome
have also followed vaccination with tetanus toxoid,
BCG, rabies, smallpox, mumps, rubella, poliovirus,
hepatitis B vaccines, and also with meningococcal
conjugate vaccine - Menactra™.
What are the symptoms of GBS?
The first symptoms of GBS are usually tingling and
numbness in the fingers and toes. This tingling is
followed by increasing weakness in the legs during
the next few days. In the mildest of cases, the
weakness may stop at this point and cause only
moderate difficulty in walking. These patients
would need canes, crutches or a walker to get
around.
In many cases, the weakness and tingling also
spreads to the arms and upper body. In some cases
the weakness spreads further and leads to complete
paralysis of the legs and arms.
In a quarter of cases, the paralysis progresses up the
chest. The patient is unable to breathe on his or her
own and needs to rely on a mechanical breathing
machine (ventilator). The muscles in the throat and
face may be affected, making swallowing
impossible. These patients need to be fed through a
tube inserted up the nose or directly into the
stomach.
How is GBS diagnosed?
The illness is diagnosed from the history and
clinical examination. Diagnosis is difficult because
the symptoms may be confused with those of other
conditions.
Two types of confirmatory tests may be helpful and
are performed in most cases:
•
•
lumbar puncture – under a local anaesthetic,
a needle is inserted between the lower back
bones and a small amount of spinal fluid is
drawn off for analysis; and
nerve function tests – electromyogram
(EMG) or nerve conduction velocity test;
these tests produce an electrical recording of
nerve conduction and muscle activity
What is the treatment for GBS?
GBS improves by itself. However, certain factors
can assist recovery:
•
good nursing and medical/intensive care;
•
physiotherapy and hydrotherapy, therapies
that relieve discomfort and prevent stiffness;
•
high doses of immunoglobulins (proteins
that form part of the body’s infection
fighting system) given by intravenous;
•
the exchange of blood plasma
(plasmapheresis); this generally reduces the
duration of the disease in severe cases if it is
done in the first few days; and
counselling to reassure the patient and
encourage the patient towards recovery.
•
Do people recover from GBS?
Most people (80%) make a total recovery. Many
spend three months or more in hospital and take a
year to recover.
About 30% of people with GBS still have some
weakness in the affected muscles three years after
they first became ill. A small number are unable to
resume their normal occupation.
Modern intensive care makes death from GBS a
rare occurrence, but is does occur in about 3% of
cases. It is rare to have GBS a second time.
Where can I get more information about
GBS?
For more information about GBS, talk to your
health care provider or contact the Halton Region
Health Department at the number listed below.
For more information contact
Halton Region
905-825-6000
Toll free: 1-866-4HALTON (1-866-442-5866)
TTY 905-827-9833
www.halton.ca
January 2008