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What is Guillain-Barre Syndrome? Print E-mail
Written by Mike Cohen   
Sunday, 18 October 2009

Guillain-Barré syndrome, or GBS, is believed to be an autoimmune disorder in which the body creates antibodies against its own tissue. In people with GBS, the antibodies generally attack the myelin sheath, or lining of the nerves. They may also attack part of the nerves themselves.

What is going on in the body?

Guillain-Barré syndrome is thought to be an autoimmune disorder that is triggered by an infection, vaccination, or other factors. It causes a severe inflammatory reaction around the nerves. The myelin sheath becomes swollen. Impulses and messages cannot travel along the course of the nerve. In time, nerve impulses are blocked.

What are the causes and risks of the condition?
Most cases of Guillain-Barré syndrome are triggered by an infection. Two-thirds of the individuals with GBS have had an upper respiratory infection or gastrointestinal infection 1 to 3 weeks before weakness develops. Other infections that may trigger GBS include:
- chlamydia infections
- cytomegalovirus infections
- hepatitis B
- HIV infections, which cause AIDS
- mononucleosis
- mycoplasma pneumonia

Some vaccinations may also trigger Guillain-Barré syndrome. These include:
- flu vaccine
- immunization against group A streptococcal infections
- rabies vaccine
- swine flu immunizations

Certain medicines have been identified as triggers for GBS. These include:
- captopril, used to treat high blood pressure
- danazol, a hormone derivative
- gold, which is injected for diseases such as rheumatoid arthritis
- heroin, a highly addictive illegal drug
- penicillamine, which is used for chelation and to treat rheumatoid arthritis
- streptokinase, used to dissolve blood clots
GBS may be triggered by a variety of other factors, such as:
- blood cancers, especially Hodgkin lymphoma
- pregnancy
- surgery
No one knows for sure why these factors trigger Guillain-Barré syndrome in some people but not in others. More research is needed in this area.

What are the treatments for the condition?
Initial treatment of GBS focuses on life support. A ventilator, or artificial breathing machine, may be needed. Fluids can be given through an intravenous line. Food can be given through a tube into the stomach.

A procedure called plasmapheresis can be effective if used early in the course of the illness. Plasmapheresis removes antibodies that may be present in the bloodstream. It also provides the person with fluids or plasma that is free of the antibodies that trigger GBS.

Immunoglobulin therapy is also used to treat GBS. High doses of immunoglobulins, or proteins from the immune system of normal donors, are given to the person with GBS. For some unknown reason, these globulins reduce the body's attack on its own nerves.

Corticosteroids, such as methylprednisolone, are sometimes given together with plasmapheresis or immune serum globulin. However, their effectiveness is questionable, and they may worsen the disease.

What are the side effects of the treatments?

Plasmapheresis is associated with a small risk of getting bloodborne infectious diseases. Corticosteroids and immune globulins may increase the person's risk for many types of infection.

What happens after treatment for the condition?
Physical therapy may be ordered to prevent contractures and other complications. Along with occupational therapy, it can be helpful in restoring the person's normal level of function. Pain medicines and physical therapy may be needed if the person has chronic pain.

How is the condition monitored?
After the acute phase of GBS, the individual will have regular visits with the healthcare provider. Any new or worsening symptoms should be reported to the provider.


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