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Guillain-Barré Syndrome

  • Guillain-Barré Syndrome (pronounced ghee-lan bar-ray) syndrome is a rare and serious condition of the peripheral nervous system. It occurs when the body’s immune system attacks part of the nervous system.
  • The exact cause of Guillain-Barré syndrome is unknown. However, most people (around 60%) develop the condition shortly after having a viral or bacterial infection. It’s thought infection may trigger the immune system to attack nerve roots and peripheral nerves.
  • The peripheral nervous system is the network of nerves that lie outside the central nervous system, including the motor nerves, which the brain uses to control the muscles.
  • In Guillain-Barré syndrome, the immune system (the body’s natural defence against infection and illness) attacks these nerves, causing them to become inflamed and stop working.

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Symptoms of Guillain-Barré Syndrome can develop quickly over a few hours. The muscle weakness often gets progressively worse within a few days or weeks.

The first symptoms usually develop two to four weeks after a minor infection, such as a cold or gastroenteritis

Symptoms often start in your feet and hands before spreading to your arms and legs. Initially, you may have:

  • Pain, tingling and numbness 
  • Progressive muscle weakness
  • Coordination problems and unsteadiness (you may be unable to walk unaided)
  • The weakness usually affects both sides of your body and may get worse over a period of several days.

In mild cases of Guillain-Barré Syndrome, your muscles may only be slightly weakened. However, in more severe cases, the muscle weakness can progress to:

  • Temporary paralysis of the legs, arms and face
  • Temporary paralysis of the respiratory muscles
  • Blurred or double vision
  • Difficulty speaking 
  • Difficulty chewing or swallowing (dysphagia), resulting in the need to be fed through a tube
  • Difficulty with digestion or bladder control
  • Fluctuations in heart rate or blood pressure
  • Some people with Guillain-Barré syndrome don’t experience any pain, while others have severe pain in their spine, arms and legs.

Neurological Physiotherapy

It can sometimes be difficult to distinguish the symptoms of Guillain-Barre syndrome from other brain and nervous system disorders. Therefore, two tests are usually used to confirm the diagnosis. They are:

  • Nerve conduction studies and electromyography (EMG) – tests that measure nerve and muscle function
  • Lumbar puncture – where a small needle is used to remove a small amount of fluid from the spinal canal for analysis
  • Blood tests may also be done to rule out other possible causes.
  • Guillain-Barré Syndrome is treated in hospital in a general ward, a neurology ward or an intensive care unit, depending on the severity of the condition. In a quarter of cases patients will need to be ventilated due to weakness in respiratory muscles.

There are two main medical treatments:

  • Intravenous immunoglobulin
  • Plasma exchange (plasmapheresis)

These treatments target the antibodies (infection-fighting proteins) produced by the immune system to prevent them further damaging the peripheral nerves.

80% of people with Guillain-Barré Syndrome make a full recovery. However, recovery can take up to a year and patients may require intense therapies such as counselling, physiotherapy, occupational therapy and speech and language therapy.

  • Some people won’t recover completely from Guillain-Barré Syndrome and up to 20% of people still experience some muscle weakness after three years.

Neurological PhysiotherapyPossible long-term complications include:

  • Lower limb weakness and immobility
  • loss of sensation that may cause a lack of coordination
  • loss of balance
  • Upper limb weakness
  • Hypersensitivity – often felt as a burning or tingling sensation
  • Some people with Guillain-Barré Syndrome also experience persistent fatigue (extreme tiredness).

In rare cases, complications can be life-threatening, particularly in the ‘acute’ phase when a person is most unwell.

  • Initially to maintain appropriate bony and muscle alignment and ensure that patients are able to sit out of bed in appropriate supportive seating.
  • To assess muscle activity, range of movement and length, sensation, proprioception and coordination.

At Physio.co.uk we work closely with our patients to provide individualised exercise programmes to increase strength and assist patients to weight bear and experience movement. In addition, we are able to provide advice on appropriate equipment to maximise safety and independence in mobility in the home in order to support 24-hour approach.

 

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