Posted: Wednesday, January 17, 2007 12:00 am
Q: My 61-year-old uncle has been diagnosed with Guillain-Barre syndrome. What can you tell me about this condition?
A: Guillain-Barre syndrome is a relatively rare neurological disorder - affecting about one in 100,000 people each year - in which the body's immune system attacks its own peripheral nerves, which transmit electrical impulses to and from the brain and spinal cord. The primary target of this attack is believed to be myelin, the material that insulates nerves in the body. Resulting damage leads to the slowing or failure of signal transmission down the nerve, which limits or prevents muscles from responding appropriately.
Initial symptoms typically include numbness and tingling followed by weakness in the extremities. Symptoms can appear rapidly, even over the course of a single day. The weakness can progress to paralysis of the legs, arms and face; impaired breathing; difficulty in speaking, chewing, swallowing and eye movement; or problems with bladder control or intestinal function.
Severe GBS may result in total paralysis, potentially dangerous fluctuations in heart rate and blood pressure, or inability to breathe on one's own. In a minority of cases, the syndrome can cause lasting physical impairment or even be fatal.
While its underlying cause is unknown, patients frequently report that symptoms begin within one to four weeks after a bacterial or viral infection such as sore throat, diarrhea, cold or flu. GBS may also be triggered by pregnancy or a medical procedure - a vaccination or minor surgery, for example - or simply have no evident reason for developing. Given the unknown cause, there is no available way to prevent GBS or to predict who will experience which symptoms and to what degree.
The good news is that most patients recover quite well from Guillain-Barre syndrome, usually within a few months. Approximately 80 percent of patients will completely recover within 12 months of onset.
Nevertheless, GBS is a serious disease that requires immediate hospitalization because of the rapid rate at which it can worsen. Early treatment is important. The sooner it is started, the better the chances of a good outcome. By reducing inflammation of the peripheral nerves, the risk of serious, permanent damage to the myelin sheath and nerve fibers - and of permanent disability - can be substantially decreased. This also can increase the speed of recovery. That's why individuals who experience tingling in their toes, feet, or legs followed by muscle weakness should seek medical attention immediately.