What is GBS?

Introduction

The disorder commonly called Guillain-Barré (ghee-yan bar-ray) syndrome is a rare illness that affects the peripheral nerves of the body. It can cause weakness and paralysis, as well as abnormal sensations. The syndrome occurs sporadically, that is, it cannot be predicted, and can occur at any age and to both sexes. It can vary greatly in severity from the mildest case, that may not even be brought to the doctors' attention, to a devastating illness with almost complete paralysis that brings a patient close to death. Because it is so rare, most of the public has never heard of the illness, or if they did, know little about it. Yet, for those effected, the illness can be severely disabling. The following Overview is directed to patients with Guillain-Barré syndrome, their families and other interested lay persons. Its aim is to briefly acquaint you with the illness' history, its cause and manner of presentation, describe some of the effects of this disorder on the patient's life and those about him or her. The term syndrome, rather than disease, is used to describe the illness observed by Guillain and others. This term reflects the recognition of the illness by the collection of symptoms (what the patient tells the physician about changes in his body) that typify the disorder.

Historical Background

In 1859, a French physician, Jean B.O. Landry, described in detail a disorder of the nerves that paralysed the legs, arms, neck and breathing muscles of the chest. Several reports of a similar disorder followed from other countries. The demonstration by Quinke in 1891 of spinal fluid removed by passing a needle into the lower back paved the way for three Parisian physicians, Georges Guillain, Jean Alexander Barré and Andre Strohl to show, in 1916, the characteristic abnormality of increased fluid protein, but normal cell count. Since then, several investigators have collected additional information about this disorder. It can affect nerves not only to the limbs and breathing muscles, but also those to the throat, heart, urinary bladder and eyes. Doctors have several names for the syndrome, including acute (rapid onset of), idiopathic (of unknown cause), polyneuritis (irritation or inflammation of many nerves), acute idiopathic polyradiculoneuritis, Landry's ascending paralysis, etc. CAUSES OF GUILLAIN-BARRÉ SYNDROME The cause of Guillain-Barré syndrome is not known. A variety of events seem to trigger the illness. Many cases occur a few days to a few weeks after a viral infection. These infections include the common cold, sore throat, and stomach and intestinal viruses, with vomiting and diarrhoea. Some cases have been associated with specific viral infections, such as infectious mononucleosis and viral hepatitis; others have occurred with a rare disease of red blood cells, porphyria. Some cases have occurred after such seemingly unrelated events such as surgery, insect stings and various injections. In the USA many cases occurred in the winter of 1976-77 in persons who received the swine flu' vaccine. Although many illnesses or other events seem to trigger Guillain-Barré syndrome, why the disorder occurs in certain patients is still not known. Research to date indicates that, regardless of the triggering event, the nerves of the Guillain-Barré patient are attacked by the body's defence system against disease-antibodies and white blood cells.

As a result of this attack, the nerve insulation (myelin) and sometimes even the covered conducting part of the nerve (axon) is damaged and signals are delayed or otherwise changed. Abnormal sensations and weakness follow.

Because Guillain-Barré syndrome often follows a viral illness, it is sometimes mistakenly thought to be contagious. However, there is no evidence that it can be caught even if a person was around the patient when they had the preceding viral infection. In fact, often the virus is no longer in the patient when they develop the syndrome.