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Guillian Barré syndrome

BY: Arku Jasmine

Mr Browne is a 35-year-old man who had a sudden onset of weakness beginning in his feet and climbing upwards towards his trunk. He also realised that he had numbness and tingling sensation in his feet.
Upon investigations in the hospital, M. Browne was diagnosed with Guillian Barré syndrome.

Overview

Guillain Barré syndrome is the result of an auto-immune response, where the immune system overreacts and attacks normal body tissue.

It is a comparatively rare condition which affects the peripheral nerves (nerves that carry information/signals from the brain and spinal cord to the rest of the body for example the muscles of your hand and take information such as touch or joint movement back to the brain).

The peripheral nerve tissue can be affected in two different ways.

One of them is when the conducting aspect of the nerve –referred to as the nerve cell body and axon- is affected.

The outcome in this case is poor and recovery may be slow or incomplete. The second way is when the insulating tissue around the nerve – the myelin sheath – is affected, resulting in demyelination of the peripheral nerves.

Myelin sheath is the covering on the peripheral nerves which helps in the transmission of messages. Damage to the myelin disrupts relay of signals resulting in paralysis.

The nerves, however, begin to recover after a period of time and total recovery is more likely to occur quickly.

Guillain Barré syndrome, typically begins in the feet and hands and progresses upwards towards the legs and trunk. The weakness generally affects both sides of the body, and it may get worse over several days.

Guillain-Barré more often than not occurs in previously healthy people.

Causes

The cause of Guillian Barré syndrome is uncertain but in most cases the condition is precipitated by a viral or bacterial infection.

The infection results in changes in the body's immune system which begins to destroy the protective covering of the nerves; hence reducing the nerves ability to relay information between the brain and muscles.

The hands and feet are areas to have the first symptoms of Guillain-Barré syndrome.

Presentation

The initial symptoms of Guillain-Barré syndrome are usually numbness and tingling in the fingers and toes with increasing weakness in the arms and legs over the subsequent days

Symptoms can range from changes in sensation to weakness in the feet and hands. It may begin with tingling and numbness, which relatively become painful.

This is because the nerves which send sensory signals from the skin to the brain have been affected as well as the nerves which supply the muscles hence resulting in increasing muscle weakness and paralysis in the arms, and especially the legs.

The weakness typically occurs swiftly over a few days or weeks. The muscle weakness and loss of sensation makes it really difficult for the patient to co-ordinate movements and even walk.

The nerves, which control skin condition, can also be affected making the skin appear swollen and shiny.

In mild cases of the condition, the development of weakness may not progress and cause moderate challenges in walking. In other cases the weakness persists and causes a total paralysis of the legs and the arms.

In some severe cases of Guillain-Barré syndrome the weakness spreads to the chest, throat and face, thereby affecting the breathing, swallowing and facial muscles resulting in the individual needing assistance from a ventilator to breathe and a feeding tube to eat.

Investigations

To confirm a diagnosis of Guillian Barré syndrome, the history of onset of presentation is taken into consideration as well as specific tests such as muscle strength, range of motion of joints, respiration and reflexes.

Diagnostic tests with the Nerve Conduction Studies and Electromyography (EMG) measures nerve and muscle function or lumbar puncture, and involves the use of a needle to remove a small amount of fluid from the spinal canal for analysis.s

By Dorothy Akua Ajabu/The Mirror/Ghana

The writer is a senior physiotherapist at the 37 Military Hospital. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.